What if a patient has Medicare?
Oxy-Gen is contracted with Medicare. However, Medicare has limited coverage for genetic testing.
For non-HMO Medicare plans, cancer panels are typically covered if the patients meet
Medicare criteria for Hereditary Breast and Ovarian Cancer or Hereditary Colorectal/Lynch
If a patient with a non-HMO plan does not meet the criteria for one of the cancer panels, they will need to sign an ABN.
For HMO Medicare plans:
Providers must obtain a prior authorization.
Deductible, coinsurance and copays may contribute to a patient’s out-of-pocket.
What if a patient has Medicaid?
Oxy-Gen is a registered provider with various Medicaid plans. However, some of these plans often do
not cover the cost of genetic testing. Prior authorization is typically required.
If Oxy-Gen has a contract with the Medicaid plan, we will submit the required information and
attempt to obtain a prior authorization.
If we are not under contract with the Medicaid plan or if the test is not covered, we can offer
our Medicaid Self Pay price.
If the patient has a Managed Medicaid plan, the provider is required to obtain the prior
authorization per the plan requirements.
Any Medicaid test sent without a prior authorization will go on hold until a path for
reimbursement has been determined.
Please contact a Billing Representative at 888-415-6757 or firstname.lastname@example.org for more information.