Genetic testing is a complex process that can impact an individual not just emotionally, but also in terms of time. The process can take weeks to complete, which only adds to the uncertainty. Insurance coverage sometimes also adds a layer of complexity to this process. Most insurance plans cover BRCA1 and BRCA2 testing if you meet the criteria for testing. Coverage for testing of other genes related to breast cancer varies by plan. Genetic counseling is usually covered if you meet the criteria for testing or have a personal or family history of cancer. Under the Affordable Care Act, plans beginning on or after August 1, 2012, are required to cover genetic testing when recommended by a health care provider. If you have a BRCA1 or 2 inherited gene mutation, the Affordable Care Act also requires coverage of counseling to help you decide if taking a medication to lower the risk of breast cancer is right for you. Some people may decide to pay for the tests out-of-pocket if their insurance doesn’t cover them. For those who don’t have insurance or can’t afford the co-payment, assistance programs may be available. Another thing to consider is the type of genetic test that will be used. A genetic counselor can help you choose the test that best meets your needs. In the past, breast cancer genetic testing only checked for BRCA1 and BRCA2 gene mutations. Now, through expanded panel or multi-gene testing, these genes, as well as others associated with a high risk of breast cancer, are checked. These panel tests look at many different genes, depending on the specific test. Researchers are studying how insights into other high-risk gene mutations can help health care providers deliver more personalized medical care. As with BRCA1 and BRCA2 genetic testing, expanded panel testing should only be done in a medical setting after a detailed discussion of the potential risks and benefits with a genetic counselor or a trained health care provider, such as a doctor or nurse. If a family member has a specific inherited gene mutation, you can consider testing for that specific mutation or expanded panel testing that includes it. One more thing to know about is the confidentiality of tests results.

Under the Genetic Information Nondiscrimination Act, or GINA, health insurance companies and employers are prohibited from discriminating against someone based on their genetic information. Health insurance companies can’t deny coverage when a person’s genetic profile puts them at higher risk for certain health conditions. It also prevents them from charging higher monthly premiums. However, GINA doesn’t prevent life insurance companies or disability insurance companies from denying coverage. If a life insurance policy or a disability insurance policy is already in place though, genetic testing will not impact it. GINA also prevents employers and other covered entities from making employment- related decisions based on someone’s genetic information. To learn more, you can visit the Risk Factors section on komen.org.