SADS Foundation :: Sudden Arrhythmia Death Syndromes Foundation

Dealing with insurance problems for genetic testing

Begin the approval process!  Do not assume your carrier will not cover testing. Even if you are denied during the approval process, you can appeal (which is how we can educate and advocate to get testing covered!). Follow the suggestions in the "What are the steps to get tested?" section below to ensure the best pre authorization process.

Appeal.   We encourage all families to appeal denials during the pre authorization phase and the claims phase (after the test has been completed).

Common reasons to appeal:  "Not medically necessary", "Out of Network" (which results in higher out of pocket expense), "Not Scientifically Proven". We have materials specific to each reason for denial and can help make the appeal process easier.

CONTACT SADS FOR HELP.  Post on our Discussion Board to get help from others, tell your story or just talk with someone who has been through this process. (or you can contact Joanne Robinson at This e-mail address is being protected from spam bots, you need JavaScript enabled to view it or call 1-800-786-7723).

Genetic Testing--Insurance Resources

Blue Cross Blue Shield TEC Advisory on genetic testing and Long QT Syndrome. The national Advisory states that it should be covered by Blue Cross. Each regional Blue Cross now has to accept this recommendation. You can also download the complete Advisory. BCBStecadvisor

 LQTS and Brugada Sample Letter Your doctor can use this letter &/or you can ask SADS to send a letter, too.

 CPVT Sample Letter Your doctor can use this letter &/or you can ask SADS to send a letter, too.

Other insurance tips and resources

If you would like to help others who have an insurance issue, email or call Joanne at This e-mail address is being protected from spam bots, you need JavaScript enabled to view it or 1*800*STOP SAD.