Medicare approval of Genetic Testing for Ataxia

If your primary insurance is medicare, did you have to get pre-approval for genetic testing for ataxia. And did it take very long for the approval to come through? It's very frustrating because they said they ordered the tests, but they are waiting for approval from my insurance (medicare). It's been almost a month now. Without the insurance coverage, they said the testing would cost upwards or $20,000 or more.

Thanks JC for your reply, but the real question is how long should approval take? I've been waiting almost a month. Is this unusual?

In my case, medicare is my primary insurance and blue cross/ blue shield is secondary. I had genetic testing for the known recessive types of ataxia. Athena Diagnostics got the approval ahead of time. I have no idea what they did or how long it took. All I know is it took a total of 6 weeks for my results (for approval and testing). I may have testing for the known dominant types (my neuro has ordered it), but I will make sure it's approved ahead of time, as I don't want any surprises, that's for sure! ;o)

Anthem Blue Cross Blue Shield which is now my primary insurance would mot pay for it for me. I am disabled but not eligible for Medicare until July 2014.

My primary insurance is Medicare and my supplementary insurance is BC/BS Managed Blue for Seniors. Last year, when I went to see another neurologist for a second opinion as to the diagnosis of Ataxia, he ordered a battery of blood tests which I went right ahead and had done the same day. I didn't seek any insurance approval because no one mentioned I might have to! Silly me! A year later I have received a bill for $600. from Medicare.. I contacted my supplelmentary and they are looking into it for me. The discouraging part was that all the tests I had were not unusual in their results and my primary neurologist said I still needed the test for a genetic basis for my problem.

Talk about being confused by the system!

I did not have the genetic testing done as I am on BCBS of IL and they are out of network with Athena and would still have to pay $5,000.00 out of pocket.

Not eligible for Medicare for 4 more years. Would like to get it done for a final diagnosis as I have been diagnosed with EA2 with a possibility of SCA6 and EA1. Just would like a definite diagnosis but cannot afford to pay the out of pocket. My son does not want to know if it is heredity. Since there is no cure for ataxia I will not get the testing done unless it is covered by insurance.

My advise is not to pay for it out of pocket as I was told the same thing as you that the tests could cost upwards to $20,000. Advise from others on this site advised not doing it also since there really is no cure.

Thank you for your input. I hope you all had a nice Thanksgiving!

That doesn't sound right to me. My dr's secretary called for me and got the answer in 15 mins. that it would cover the genetic testing. I haven't gone back for the blood test yet, but I will double check. I don't trust everything I hear.