Is Medicare Paying for Genetic Testing?

In July of 2012, there was a landmark event in the field of personal DNA-based healthcare.

The Medicare health insurance plan agreed to reimburse patients for some genetic tests. This announcement by Medicare (justifiably known as the “scrooge” of healthcare insurers) helps to legitimize the medical practice of DNA or genetic testing – also known as Genomic Medicine, or Personalized Medicine.

Medicare will cover the cost of identifying people with a mutation to the genes CYP2C19 and ABCB1. These gene mutations could diminish the effectiveness of Plavix (clopidogrel), which would then increase a person’s risk for adverse cardiovascular events. (Plavix is a common and important medication prescribed for various heart and stroke conditions.)

This event was a major step in the development of “Pharmocogenetics,” which is the use of gene testing by physicians, in order to improve the selection of the most effective medications and dosages for a patient’s personal healthcare.

Furthermore, the field of Genomic and Personalized Medicine will expand more rapidly into mainstream medical practice as more DNA/ genetic tests become reimbursed by health insurance companies. Doctors are more likely to order and utilize these tests if the patients can afford them. The lack of affordability has been one of the major reasons why medical science advances much more quickly than the quality of our health services.

My blog will continue to highlight similar discoveries and developments in Genomic and Personalized Medicine. Also, I highly recommend the following book for an excellent overview of the future possibilities in this advancing field of medical practice:

Outsmart Your Genes: How Understanding Your DNA Will Empower You to Protect Yourself Against Cancer, Alzheimer’s, Heart Disease, Obesity, and Many Other Conditions, by Brandon Colby, MD, 2010