After you order, you will receive an email or text linking to your personalized out-of-pocket cost estimate and payment options.
Your estimate is not a bill or a guarantee of your costs. Your actual costs and benefits may vary depending on your insurance company and your specific benefit plan.
We start to process your sample immediately after we receive it to make sure you get your results as soon as possible.
- Personalized estimate of out-of-pocket cost
- Information on the Counsyl Access program
- What’s next for your test
- Access to online resources
Your estimate is based on the information provided with your order and the information we receive from your insurance company. Your actual costs and benefits may vary depending on your insurance company and your specific benefit plan.
I have questions about my estimate
We are here to help. Take a look at answers to the frequently asked questions below. If you still need assistance, please view our FAQs.
What is the difference between paying with insurance and paying without insurance?
You have the option to pay for your Counsyl test by filing through insurance or by paying without insurance.
If you have other medical costs to file with insurance this year, such as pregnancy or cancer related costs, you may want to consider filing through insurance because that amount will count toward your yearly benefits (such as deductible and maximum-out-of-pocket).
If you choose to pay without insurance, the amount will not count toward your insurance benefits for the year. This may result in paying more for your healthcare expenses because you are not using your insurance benefits.
Why do people with insurance have different out-of-pocket costs for the same test?
At Counsyl, we’re working hard to make genetic information accessible to anyone who wants it. Counsyl has contracted with many health plans to provide patients affordable access to our DNA tests. There are many individual factors involved in healthcare costs and pricing.
For those with insurance, your actual out-of-pocket cost will depend on:
- The fraction of the total cost that your insurance covers, which varies by plan
- The amount you have already paid for healthcare expenses this year
- If your insurance provider is in network or out of network with Counsyl
- Meeting medical criteria to have insurance cover DNA testing
For those without insurance we offer a cash pay option.
What if I did not receive an estimate?
There are several reasons why you may not have received a personalized estimate or it did not include a specific dollar amount.
- Your contact information was incorrect or not provided with the order and we were not able to send you your estimate.
- The insurance information provided with the order was incorrect or expired.
- Your insurer did not respond with your benefits and we were unable to determine an estimated cost.
What should I do next?
Contact Counsyl to ensure we have the correct contact and insurance information on file for you.
If your insurer did not respond with your benefits, you will need to contact them directly. How do I pre-verify my insurance coverage?
What if I need prior authorization?
Counsyl will work with your healthcare provider and your insurance to request a prior authorization for our Prelude and Reliant DNA Tests. Some insurers have special requirements such as pre-test genetic counseling. You will be notified in your personalized estimate if prior authorization is required and if there are any special requirements for your plan.
Counsyl cannot guarantee that authorization will be provided in all cases and prior authorization is not a guarantee of coverage. Coverage may vary depending on product, location, specific benefit plan or the payor’s medical policy guidelines.
At Counsyl, we’re working hard to make genetic information accessible to anyone who wants it. We have several options to make the pricing affordable to ensure that patients get the care they need.
No-charge testing is available for those who qualify.
Interest-free payment plans are available for every patient, regardless of financial need.
We offer a cash pay option for patients who choose to pay without insurance. This option is only available before we file a claim with your insurance.
Learn more about billing
Learn more about how we make screening more accessible
Learn about Counsyl’s unique billing experience and basic insurance terminology
Learn about each test, what affects your final cost, and available payment options
Learn about your estimate and answers to common questions
Understand your bill, how to pay, and available payment options