Is Genetic Testing For Lynch Syndrome Covered By Insurance?

Is Genetic Testing For Lynch Syndrome Covered By Insurance?

Most of the insurance companies provide coverage for genetic testing. Most of them provide 90 to 100 per cent coverage for genetic testing. Medicare and many other insurance companies will usually pay for the genetic tests that are recommended by a genetics specialist and are considered to be medically important and necessary.

  • There are several tests which the specialist may recommend if there is a suspicion about lynch syndrome.
  • Family history has to be taken into consideration.
  • The specialist will first ask about the medical history. He will ask if there are relatives in the family that are suffering from tumors or cancers that are lynch syndrome associated. These cancers might be colorectal cancer, ovarian cancer, endometrial cancer, stomach cancer etc.
  • The specialist will ask if there is someone in the family who has developed cancer at an early age, or an age which is unusual for that type of cancer.
  • Or if there are more than one generation affected by a particular type of cancer.

    Is Genetic Testing For Lynch Syndrome Covered By Insurance?

Testing For Tumor

If the person or someone in the family has developed any cancer, special types of tests for that cancer may detect if the cancer has any link with lynch syndrome. This will be helpful in ascertaining if one’s cancer was caused by the lynch syndrome.

These tests may include one or both of the following tests-

Immunohistochemistry Testing (IHC)- in this method some particular dyes are used to stain the tissues. Whether the staining is present or absent, will indicate if certain types of proteins were present in the tissue. The absent proteins will tell guide doctors as to which genes were mutated, causing the cancer.

Microsatellite Instability Testing (MSI)- in this method, the instability or errors in the sequences of DNA are detected, which may be confirmative of lynch syndrome.
If any of the above tests is positive, it may indicate that there is some problem with the genes functions that are associated with lynch syndrome. However, it cannot be said for certain, because these gene mutations might only be present in cancer cells, while other cells might be normal. Whereas, in lynch syndrome, all the cells in the body will be showing this gene mutation. In such cases, genetic testing can give confirmatory results.

Lynch Syndrome Genetic Testing

Some particular genes will have mutations in lynch syndrome. In order to see whether one is having Lynch Syndrome, the doctors will perform tests for those particular genes that are linked with Lynch Syndrome, so that it can be ascertained if they are genetically mutated.

With the genetic testing results, there may be one of the following results-

The Genetic Test May Turn Out To Be Positive– If the genetic test comes positive, it means that a genetic mutation has happened. However, that does not compulsorily mean that one has cancer or will get cancer in future. But it surely increases one’s risk factor of getting some types of cancers in life. How high the risk will be, that totally depends upon which gene underwent mutation and hence, will be different for different persons.

The Genetic Test May Turn Out To Be Negative– if the genetic test comes negative, it means that the gene mutation was not seen and perhaps one does not suffer from Lynch syndrome. However, if someone in the family has cancer, the risk factor still remains the same.

Sometimes a variation in gene may be seen, which may be of an unknown or unspecified origin. Though, genetic testing usually may be helpful in giving the desired results, at times, some level of uncertainty may still remain.

Most of the medical insurance companies and Medicare generally provide a coverage of 90 to 100% for the genetic testing which may be required for lynch syndrome. The genetic testing should be recommended by a genetics specialist and should be medically important and necessary for the coverage to be granted.

Pramod Kerkar, M.D., FFARCSI, DA
Pramod Kerkar, M.D., FFARCSI, DA
Written, Edited or Reviewed By: Pramod Kerkar, M.D., FFARCSI, DA Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:July 22, 2023

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