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• How are genetic services defined in your plan?

• What is the policy regarding pre-existing and pre-known (asymptomatic) genetic conditions?

• Can the plan list specific conditions that are covered or excluded?

• Can the plan provide a list of covered services and a list of exclusions?

• What coverage is included if you see a genetic services provider? Would the plan cover DNA testing? Genetic counseling? Diagnostic testing? Carrier testing? Pre-natal diagnosis? Laboratory fees?

• Does the plan have a list of tests that are covered and excluded? Would the plan cover DNA testing? Chromosome testing? Biochemical testing? tissue biopsy?

• If a genetic disorder is suspected or confirmed, what will be included for genetic counseling and testing of other at-risk family members?

• Which family members could receive genetic services (i.e. husband of a pregnant woman)? Which services?

• For family members covered by your plan, will laboratory testing, such as DNA, chromosome, biochemical, be covered if applicable?

• If a specific genetic disorder is suspected or confirmed by a general geneticist, and a specialty provider is available, will your insurance cover a visit to a specialty genetics clinic or a specialty provider?

• Does your plan cover only a referral for genetic evaluation/diagnosis, or will coverage be provided for long-term management by a geneticist or specialty provider?

• Does your plan provide coverage for treatment if available/applicable? Would the plan cover medication? special formulas? therapies (speech, physical, occupational)?

• What is the process for referral to a genetic services provider?

• What approvals are needed, by whom, and how long will it take?

• What is the process for appeals or resolution of disputes?

  For prenatal counseling/diagnosis, to whom would you be referred? A geneticist? Genetic counselor? Perinatologist? Obstetrician?

• What are the qualifications of the genetic service providers in you insurance plan?

• Are the providers board certified/eligible by organizations such as the American Board of Medical Genetics or American Board of Genetic Counseling?

• How are confidentiality issues handled by your plan?

• How will your confidentiality be protected?

• How will the confidentiality of other family members be protected?

• Is your employer able to obtain medical records or results of testing?

• Does your state have laws that protect confidentiality regarding genetic disorders?