What is the Role of a Genetic Specialist?
Genetic Specialists are health professionals who have completed advanced training in genetics and all aspects of risk assessment, informed consent counseling, results interpretation, result disclosure and guiding risk management discussions with patients and their families. If you have significant cancer family history and you think you might be at risk for an inherited form of cancer (take our Hereditary Cancer Quiz), it is important to have genetic counseling. One of our genetic specialists will review your family medical history, talk to you about the role of genetics in cancer, perform a hereditary cancer risk assessment, offer testing when appropriate and meet with you after the testing is complete to review your results. Both visits with your genetic specialist are very important parts of the process. The initial visit is critical for identifying whether genetic testing is appropriate and to help patients understand how testing can be beneficial or eliminate unnecessary testing for some. The visit following testing is also extremely important as your genetic specialist with review your results and recommend a personalized cancer screening and prevention plan, based on published medical guidelines. A visit for genetic counseling is a vital part of the genetic testing process and should always be included in the healthcare plan for anyone with increased risk of hereditary cancer syndrome.
What Factors Might Indicate Hereditary Cancer Syndrome?
There are some common factors in families that have hereditary cancers. These factors include, cancers diagnosed at a younger age than usual, similar cancers in multiple family members, Ashkenazi Jewish ancestry, multiple cancers on the same side of the family, a close relative with cancer in more than one site in the body and a known gene mutation, such as BRCA 1/2 in the family. Take our quiz to see if you have a family history that would indicate that you should discuss genetic testing with a genetic specialist. Our Family History Tool can be helpful in reviewing your family history in order to accurately discuss your risk factors.
Will My Health Insurance Cover Genetic Counseling and Testing?
The majority of health insurance carriers cover both genetic counseling and genetic testing. Typically they will cover predictive genetic tests if the patient meets the criteria based on their family history and other risk factors. Most insurance companies will also cover genetic counseling before and after the actual test. Patient experience with our primary testing lab, is 85% of patients, meeting medical criteria, pay nothing out of pocket and those who do owe a co-pay for deductible pay, on average, $54. The genetic counseling appointment is covered by most carriers as a specialist visit and therefore requires the standard specialist office visit co-pay and/or deductible. The lab typically contacts the patient with information regarding patient financial responsibility before the test is performed. HCC is an in-network participant with the following insurance companies: Aetna, Blue Cross Blue Shield, Cigna, Medcost, Medicare and United Healthcare.
Who Can Have Access to My Test Results?
All aspects of information sharing and availability will be discussed in depth by the genetic specialist at the initial visit. There are laws in place, HIPAA (Health Insurance Portability and Accountability Act) and GINA (Genetic Information Nondiscrimination Act), that work together for the prevention of genetic discrimination based on test results. There are some exclusions in these laws and this is an important discussion with the genetic specialist to determine whether testing is appropriate. All providers involved in the counseling and testing process are bound by the privacy laws, including our office, testing lab and referring physician.
What Can I Expect at My Visits?
Each visit will take approximately 30 minutes.
At the initial visit, your genetic specialist will go over an in-depth family health history. It is necessary to come to that visit with as much family cancer-related history as possible so that a complete assessment of your risks can be made (complete the Family History Tool). They will discuss how families inherit cancer risks and how genes are passed on to children. If the conclusion of this review indicates a high potential of a gene mutation, they will then discuss the genetic test and any other pertinent factors in making the decision whether to proceed with testing.
At the visit following testing, you will be shown the test results and the genetic specialist will discuss the interpretation with you. You will be provided with options for the medical management of risks, outlining opportunities for preventive measures to help reduce the possibility of developing cancer and the correlating referrals. You will also learn about risk factors for family members, including children, and how to discuss the results and potential risks with them. This is an extremely important appointment as there are many issues to be covered. It is highly recommended patients bring a family member with them to this appointment. Knowing how to use the test results, whether positive or negative, is critical in maintaining good health for the future.