DNA Testing - MaterniT21 Plus or Counsyl?

One of the decisions that expecting moms need to make after 10 weeks is whether or not to take screening tests for genetic problems. Typically, people take a screening test like a NT scan and/or DNA tests like MaterniT21 and Counsyl before considering amniocentesis, which is a diagnostic test. 

A NT scan detects the possibility of Down syndrome at an accuracy rate of 70-80%, while DNA tests can detect the possibility of several genetic problems including Down syndrome, Edwards syndrome, Patau syndrome, and Sex chromosome abnormalities at an accuracy rate of 98%. So, which one to take? Given my advanced maternity age (44!), it was a no brainer. I skipped the NT test and proceeded with a DNA test. 

Now, another question. Several companies offer similar DNA tests - MaterniT21Plus by Sequenom, Informed Pregnancy Screen by Counsyl, to name a few. Which one should you go with? Below are a few things to consider. 

1. First, check your insurance coverage. If you are under the age of 35, your plan may not cover these tests. 
2. Check which tests your plan cover. Some providers offer several levels of services (e.g., MaterniT21Plus - basic vs. MaterniT Genome - more advanced DNA analysis), so find out which test your plan covers. Most insurance covers only the most basic test. 
3. Even if your plan covers a DNA test, check if providers you are interested in are in-network or out-of-network. You are very lucky if they are in-network. Call the provider and get an out-of-pocket estimate. 
4. My plan covered MaterniT21Plus and Informed Pregnancy Screen, but neither was in-network. My plan is a high deductible plan, and contributing $$ to the out-of-network deductible was like throwing money into a ditch. So, I went for the self-pay option. Call the providers and get a cash price. 

Below is my experience with Sequenom and Counsyl.

Counsyl was more up-front about their cost. Their cash price was $349. If I chose to use my insurance, the out of pocket estimate was about $800. On the other hand, Sequenom insisted that I use my insurance, and told me that the out-of-pocket estimate would be $900. They were very reluctant to give me a cash price, and it wasn't that different from the price with insurance ($800). 

One thing that made me uncomfortable with Sequenom is a promise that sounded rather skeptical. After I explained that there is no way that I can meet my out-of-network deductible, and I would end up paying the full price myself, they told me to submit a claim anyway, and call them again if I am hit with a huge bill. Then, they said they'd adjust the price to $250. Really? 

I Googled this, and found out that many people received the same proposal. Some people did receive this deal as promised, but I also read horror stories. Some said that their insurance covered only a small portion, and was responsible for a bill over $1,000. Then they called Sequenom and was told that the price adjustment cannot be made because the insurance paid a part of the bill. 

I've had enough experience with billing departments saying one thing before rendering a service and saying another afterwards. I didn't want a likely hassle for a potential saving of $100 ($349 Counsyl, maybe $250 Sequenom), so, I went with Counsyl. 

Billing with Counsyl was a breeze, with no hidden costs. I also liked how they made the result available online in only 5 days, and offered a free counseling with a genetic counselor to go over the results. All in all, I was very happy with their service. 

Test result? Everything was normal! What a relief.