From the Research
I cannot definitively state whether PGT (Preimplantation Genetic Testing) is covered by Highmark insurance as coverage varies based on specific insurance plans, policy details, and individual circumstances. Highmark, like many insurance companies, may cover PGT in certain situations, particularly if there's a medical necessity such as known genetic disorders in the family. Coverage decisions typically depend on your specific Highmark plan, whether you meet medical necessity criteria, and if prior authorization has been obtained. To determine if your specific Highmark insurance plan covers PGT, I recommend contacting Highmark directly using the customer service number on your insurance card, speaking with a benefits specialist at your fertility clinic, or reviewing your policy documents for details about fertility treatment and genetic testing coverage. Some key points to consider when evaluating PGT coverage include:
- The type of PGT being performed, such as PGT-M for monogenic disorders or PGT-A for aneuploidy screening 1
- The presence of genetic disorders in the family, which may impact medical necessity and coverage decisions 2
- The specific details of your Highmark insurance plan, including any exclusions or limitations on fertility-related genetic testing 3
- The potential benefits and limitations of PGT, including the risk of false positives or false negatives, and the impact on reproductive decision-making 4, 5 Insurance coverage for fertility-related genetic testing can be complex, with some plans offering full coverage, partial coverage with copays or coinsurance, or no coverage at all. It's essential to carefully review your policy and consult with a benefits specialist to understand your specific coverage and any requirements for prior authorization.