Frequently Asked Questions

Will this affect my ability to get health insurance in the future?

Results of genetic testing should not affect anyone’s ability to get health insurance. A federal bill called GINA, which stands for Genetic Information Non-discrimination Act, was passed in 2008. This new law prohibits health insurers from dropping or denying insurance coverage or charging higher premiums based solely on genetic test results.

Employers are also not legally allowed to fire someone or deny someone employment because of their genetic status.

And remember, although most insurance companies will cover the cost of testing, the results are confidential and are not released (not even to the insurance company) without a signature from the patient. Find more information about GINA.

Will my insurance cover this?

Most insurance companies will cover all or part of the cost of these services.


If you have an HMO, your doctor’s office can request prior authorization for an appointment. Please note that authorization for the appointment is separate from authorization for testing. Once we receive your completed family history forms, we will request authorization for genetic testing, if appropriate. The authorization process for testing may take up to one week. Genetic testing is not appropriate/available for all families, and most people find the consult and assessment of their family to be very valuable, even if testing is not performed.

Medicare, MediCal and Tricare

Government insurance plans such as Medicare, MediCal and Tricare do not cover the cost of genetic counseling, and if you have a supplemental policy, they will follow Medicare guidelines and will not cover the service. The fee for genetic counseling (which includes the consultation, coordination of testing, interpretation of results for you and your family and a comprehensive written report) is modest and will be collected when you arrive for your appointment. There may also be a small fee if you have blood drawn for testing, but there is usually no cost for the testing itself.


Because each plan is different, we recommend that you check with your insurance company for specifics. Our insurance reimbursement specialist may also be able to assist you. When you are checking about coverage, your insurance company may ask you for the CPT code. We encourage you to contact one of the Hoag Financial Navigators regarding coverage: Laura Clark at 949-764-6643 or Eduardo Rodriguez at 949-764-6772. If you have not been seen at Hoag within the past 30 days, please email a copy of your insurance card (front and back) to so that we may verify your benefits prior to your appointment. The procedure code (CPT) for the consultation is 96040. If we meet again to discuss test results in person, there may be an additional charge for this appointment. The cost for genetic testing is separate, and fees for genetic testing are billed by the testing laboratory. Hoag financial navigators are therefore not able to provide you information about these charges; however, your genetic counselor will discuss testing costs with you at your appointment and most laboratories are able to give an estimated out of pocket quote prior to starting the test

Why do I need genetic counseling?

“My sister was just found to have a BRCA mutation. I don’t need genetic counseling, but can you tell me what test I should have? Is it covered by insurance? Is it important for my brother to test, too? If I have it, does that mean my kids have it too?”

These and many more, equally important questions are exactly what genetic counseling is all about. Of course we provide support when it’s needed, but our goal is to make sure that we assess your personal and family history for all known hereditary cancer susceptibility conditions, and for those who would like to pursue genetic testing, to make sure the right test is ordered on the appropriate person and most important, that the results are interpreted correctly.

Misinterpretation of genetic test results poses a great risk and can have a significant impact on a family and their ability to get appropriate information and follow-up care, when testing is ordered by those who are not board certified in genetics.

Genetic testing for hereditary cancer can sometimes arouse certain emotions or painful memories. We are able to inform patients of helpful resources as needed and make connections with those who can provide appropriate support.

After your appointment, you will receive a complete written report which you can share with your family. In this report, we will outline your risk for cancer, what your results mean (if applicable) and possible recommendations for screening for you and your family members.

Going forward, we invite you to stay in contact with us for information about new discoveries in genetics which may result in additional testing that would be appropriate for you, changes in medical management guidelines, or research opportunities. We are also available to assess any new developments in your family history.

As a patient, you deserve the best opportunity to get the right answers about hereditary cancer – from an expert. It’s too important not to see a specialist.

What if I’ve already had cancer?

If you have been diagnosed with cancer, you have probably wondered why this happened. Hereditary cancer assessment may help you to finally get the answer to this question, and the answer may provide both you and your family with important information. 

A person who has cancer or who has had cancer does not want it to happen again. People with an inherited predisposition to cancer are often at risk of getting cancer a second time. If this is the case for you, then this knowledge can help you take steps to dramatically lower the chance of getting cancer again.

Also, if you’ve been diagnosed with cancer, your family is likely not only concerned about you, they’re probably also worried about their own chance of getting cancer. Hereditary cancer assessment can help to clarify their cancer risks and what steps they should be taking.

For some cancer types, genetic test results can help inform your medical oncologist about which treatment is best for you.