Using Insurance

Are you covered for a PGx test?

Use the guide below to determine if you might qualify to use your insurance for a PGx test.

Best to pay online when:

  • No pre-existing conditions
  • Not currently taking any medications
  • Just wanting to learn more about your genetic makeup
  • Don't currently have insurance
  • Taking a test now in case it is useful in the future
  • Want a PGx test quickly

Best to use insurance when:

  • Dealing with a chronic condition
  • On multiple medications
  • On Medicare or Medicaid
  • Existing healthcare provider who knows your medical history
  • Have a known genetic variation
  • Have a history of adverse drug reactions

For the most straightforward and timely approach it's best to pay for your test directly online. Especially if you have not met your deductible or have high out-of-pocket costs.

However, if you are on Medicare, Medicaid, or have commercial insurance, with an existing healthcare provider that knows you and your medical history well, it’s possible to order your test through insurance if there is medical necessity. Using insurance for your PGx test may reduce your out-of-pocket costs, but it also can delay getting a test shipped to you because it requires additional steps to be completed by your healthcare provider.

To use insurance:

  1. Fill out the form below and we will reach out to gather more information from you.
  2. We will contact your provider and let them know you wish to take a PGx test from Patients Choice Direct.
  3. Your provider will need to login to our portal and provide the required medical information such as insurance, medical necessity, patient history, symptoms, and diagnosis, etc.
  4. Once approved by insurance, an office visit may be required for sample collection.
  5. Depending on your insurance policy you may still be responsible for a small portion of your test. Most Medicare patients pay $0.00.
  6. Results will be available for you and your provider to review.