Cost and Coverage

We believe personalized medicine should be a standard of care, which is why part of our mission is to make our technology affordable.

What you can expect to pay for Genomind testing and services

Our commitment to you: If using insurance for testing, we will obtain your consent before processing your results if your total out-of-pocket cost will exceed $399.

Commercial insurance (US only)

The average out-of-pocket cost is between $0 and $399.

Genomind coverage varies by insurance plan. You may have to cover a portion of the cost, such as a copay or deductible.

Health Savings Account (HSA) and Flexible Spending Account (FSA) funds can be used to cover 100% of any out-of-pocket costs you incur for Genomind services. 

Traditional Medicare (Part B)

You will pay $0 out-of-pocket if coverage criteria is met and the test is ordered by a PECOS enrolled clinician.

Genomind is covered nationally by Medicare Part B.

Medicare Advantage (Part C)

The average out-of-pocket cost is between $0 and $399.

Genomind is covered by Medicare Advantage in some instances, but you may have to pay a portion of the cost.

Medicaid

Residents of covered states with covered plans will pay $0 out-of-pocket. 

Genomind is covered by Medicaid in most states, and depending on your plan, your clinician may be asked to complete a prior authorization. If your state or plan is not covered, we will contact you prior to processing your sample.

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What if you still can’t afford Genomind?

We never want finances to prevent you from accessing safer, individualized treatment. This is why we provide numerous resources to help you navigate payment.

One of these financial options might work:

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payment plans

 

Genomind has partnered with Affirm, which allows you to split out-of-pocket costs into more-affordable monthly payments. You can spread the costs over a 3, 6, or 12-month period.  

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patient assistance program

Genomind offers patient assistance to individuals (US only) based on household income, and household size. Individuals who qualify and apply for the program are eligible for reduced-price testing based on the federal poverty guidelines. Contact us to learn more or download the application here.

What is the process for payment?

Frequently asked questions (FAQs) about cost and coverage

Coverage varies depending on your insurance plan. If you are unsure about your plan coverage or anticipated costs, please contact your insurance provider.

If your insurance denies coverage, Genomind may file an appeal to pursue coverage on your behalf with your insurance company. We may need to contact you or your physician during the appeal process, and we won’t bill you for services not allowed by your insurance company.

If you are using insurance and have questions about coverage, please contact your insurance provider. Your insurance provider will be able to give you cost expectations specific to your plan.

If you have outstanding questions about the billing process, please contact us here.

An Explanation of Benefits (EOB) statement is not a bill from Genomind and is generated by your insurance company. Each time your insurance company processes a claim submitted by you or your healthcare provider, you will receive an Explanation of Benefits (EOB) statement to explain how they process the claim. An EOB explains how your benefits cover the particular claim. It includes the date you received the service, the amount billed, the amount covered, the amount your insurance company paid, the amount credited toward any deductible, and any balance you may be responsible for paying the provider. If you receive an EOB and have questions about it, please contact your insurance provider.

Sometimes insurance plans send payments to the patient rather than to the healthcare provider or the laboratory. If you receive a check, you are responsible for ensuring Genomind receives the payment – by endorsing the check or paying the bill on our online portal.

To endorse the check:

  1. Sign the back of the check and write “Payable to Genomind, Inc.” under your signature.
  2. Mail the check and a copy of the EOB to the following address:

DEPT CH 17047

Palatine, IL 60055-7047

Attn: Billing Department

To pay the bill if you have already cashed the check:

Pay the balance directly to Genomind by personal check, money order, credit or debit card. Payment must be in the same amount as the check you received.

  • Personal checks and money orders may be sent to the same address listed above in Step #2. We advise against a money order since it is not as traceable as the other payment methods.
  • Credit or debit card payments must be made over the phone. Please call our Customer Service team (877-895-8658) to do so.
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If you would like your ordering provider to submit a prior authorization before testing, please contact us (select the “Other” option). Our team can provide you with the information your provider will need when contacting your insurance plan.

A prior authorization is not a guarantee of coverage, so even if a prior authorization is obtained, you may still be responsible for an out-of-pocket cost. 

Yes, just let your provider know that before they submit the order for your test.

Since the Genomind pharmacogenetic testing report contains information about prescription medication and dosages, the report must be ordered by a prescribing clinician per FDA guidelines. You should not make any changes to any medical care (such as medications, diet, exercise, etc.) without consulting your clinician.

We accept all major credit and debit cards, as well as HSA and FSA. We do not accept checks or money orders for out-of-pocket payments. 

We only accept payment for out-of-pocket costs through our online portal, for which you will receive access via email. We do not accept payments over the phone.

Your cost is dictated by the insurance information your clinician submits to us. If you believe your clinician submitted inaccurate insurance coverage information for you, please contact our billing department and have your requisition ID number ready so that we may identify your case.  

To me, using this service is a no-brainer. It can save time, money, and angst on appointments and medications that aren’t likely to work for you because of the way you’re hard-wired.

Brandon B., Genomind PGx Patient

Take the first step today!

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