Hi Lisa,

I had genetic testing done for my son to find out what kind of CAH he had and to verify his diagnosis of CAH.

My insurance company also said that they do not cover genetics because of the medical necessity. I called my husband human resource lady and told her my problem. She contacted the insurance administrator and he asked for me to write a letter explaining why it was medically necessary.

I wrote a three page letter. They did accept my request but I was surprised to find out that out of the $600.00 that I paid, they only reimbursed me $180.00.

I was upset and I called to find out why they reimbursed such a small amount. It turns out that on my policy I have the 80/20 split and they only considered part of the the customary cost was. So, I was stuck with the rest but at least they paid some of it.

The moral to this story is keep bugging them with letters and phone calls from you and your doctor. They have to consider it medically necessary. In the long run, it just might save them money!

Good Luck,

Sandra