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. Author manuscript; available in PMC: 2015 Oct 29.
Published in final edited form as: Nat Biotechnol. 2015 Sep 8;33(9):900–902. doi: 10.1038/nbt.3322

Table 1.

Payera coverage policies for gene panels including BRCA1/2

Aspect of payer coverage Percentage of policies satisfying criteria (number/total relevant policies)
Payers with any relevant coverage policies 76 (13/17)
Panels considered medically necessary and covered 0 (0/13)
Panels covered only if all individual components are medically necessary 23 (3/13)
All panels considered investigational/experimental 54 (7/13)
Specific panels considered investigational/experimental 23 (3/14)
Payers with no relevant coverage policies 24 (4/17)
a

Payers include United Healthcare, Anthem, Aetna, Health Care Service Corporation (HCSC), Cigna, Humana, Health Net, Highmark, Independence Blue Cross, Blue Cross Blue Shield (BCBS) Michigan, CareFirst BCBS, BCBS Tennessee, BCBS Alabama, Blue Shield of California, BCBS Florida, Medical Mutual of Ohio and BCBS Massachusetts. These payers combined represent 158,974,237 covered lives.