Is Oncotype Dx Test Covered By Insurance

Your role in insurance coverage Medicare covers the Oncotype DX Genomic Prostate Score ® (GPS) test for eligible patients (NCCN very low, low, and favorable intermediate-risk disease). We assist your patients through the claims with their insurance company, including with your permission, help with appeals for any denial of coverage.. Medicare and several private health insurance companies will help cover the cost of an Oncotype DX test for invasive breast cancer. For DCIS, Medicare has established coverage of the Oncotype DX, but insurance companies may not yet cover it.. The Medicare program and several other major insurance companies have agreed to cover the Oncotype DX test. According to Genomic Health, about 90% of insured people in the U.S. are members of a plan that covers the test.. Oncotype DX is covered by most insurance plans. The competing MammaPrint test helps to estimate the risk of recurrence or distant metastases in early-stage breast cancer patients, whether their tumors are ER+ or ER-. Thus, it has broader applicability than Oncotype DX..

Hi Nancy, I have military insurance and the Oncotype test was not covered. They called me and told me it was not after they drew my blood and told me it was a $4,000.00 test. They were very nice and said that they would submit my claim thru my insurance and would rebut it if it came back not approved.. Oncotype DX is a test done that may predict how likely your breast cancer is to return and if you will benefit from having chemotherapy in addition to hormone therapy. The test results can help you and your doctors make a treatment plan that’s right for you..

Your Oncotype DX test report includes a Recurrence Score result (for patients with early-stage invasive breast cancer) or a DCIS Score result (for patients with non-invasive breast cancer), which is a number between 0 and 100. The lower the Recurrence Score or DCIS Score, the lower the chances are that a woman's breast cancer will come back .... From January 2020, the "Oncotype DX Breast Recurrence Score" test is reimbursed by the health insurance companies at an extra budget of 3,296.50€. This is explicitly the only test that the Federal Joint Committee (G-BA) has included in the contracted medical care..