Has anyone reccently done NIPT testing with Cigna? They told me it will be fully covered if it’s a “medical necessity” but then wouldn’t define what criteria that is. I’ve heard of people having issues with it being covered if you’re not high risk (over 35, something abnormal on a scan, etc.). Does anyone have any insight to how strictly Cigna defines “medical necessity” in practice?

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Depending on the NIPT provider, it’s worth inquiring their cash/self pay rate. For me, it was $200 to self pay or $7k if run through insurance… which, is a whole other discussion to be had. But, just a 5 minute phone call got the insurance claim retracted and a $200 charge verified.

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I had the same question and asked Cigna and they weren’t very helpful. My doctor used Natera and I paid $180 for Horizon and $105 for Panorama (I had already hit my deductible). Not sure about other NIPT providers but Natera has a separate cash price (I think around $250-$350 depending on the test(s)) and you have the option of paying the cash price if it ends up being lower than using insurance (you just have to talk to their billing dept.).

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My doctor recommended just paying cash 2 years ago. Was over 35.

Definitely get the insurance quote beforehand. My first one I paid over $1k. My OB changed who did the tests by my second pregnancy and it was only like $100 the second time. Both through insurance. If insurance doesn't cover much ask the company what the cash price is.

I have the Natera tests done. I am 28 and this is my first pregnancy and was not considered high risk. The regular genetics test was fully covered (by Anthem) and carrier testing ended up costing around $400 (deductible not met) after insurance. With a total of initial charges being over $20k for both tests I’ll take $400

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