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.
- First, check your insurance coverage. If you are under the age of 35, your plan may not cover these tests.
- 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.
- 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.
- 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.