Patient information about insurance coverage (in the US) and assistance from Agendia

Our mission is to ensure all breast cancer patients have access to important, and clinically relevant molecular diagnostic testing empowering patients and physicians to make the most informed treatment decisions.  Agendia understands that costs associated with a patient’s diagnosis, treatment, and management of breast cancer can potentially pose a financial hardship which may influence a patient’s decision in selecting diagnostic and treatment options. The following information will inform you about financial responsibility associated with performing any of Agendia’s tests.

Q: How much will I personally have to pay for my test(s)?

A: Many insurance carriers cover most types of genomic testing for breast cancer. Like each patient, every case is unique, and the average out-of-pocket amount varies based on: insurance benefits, what portion of your deductible has been met and your co-pay amounts. If you have active insurance coverage at the time of testing, Agendia can provide you with an estimate of your financial responsibility based on your specific benefit levels. Please call 888.363.7868 and one of our Patient Advocate Representatives will gladly assist you.

Q: What are my payment options if I have a balance due?

A: If payment is required after your insurance company has determined their coverage, Agendia will work on your behalf to ensure that the insurance company has processed the claim at the highest benefit level to minimize any out-of-pocket expense. After a full review, an invoice will be issued for any difference in coverage. If you are interested in arranging an interest-free payment plan, please contact us and one of our Patient Advocates can assist you with this.

Q: What if I get a bill from Agendia for more than I expected?

A: Please contact us and one of our Patient Advocates will work to resolve the discrepancy in an acceptable and timely manner. They can be reached at 888.363.7868.

Q: My insurance company sent me something that looks like a bill for this test. Should I pay it?

A: Your insurance company may send you one or more Explanation of Benefits (EOB) statements related to our test(s). This is not a bill from Agendia. Agendia can submit an appeal(s) on your behalf during the claim review process and each appeal submitted will generate an EOB from your insurance company. You do not have any financial obligation for the test, unless you receive an invoice from Agendia.

Agendia is a compassionate company offering a wide range of financial assistance programs based on individual financial status. Agendia offers the following programs to meet your financial needs:

  • Interest-free payment plans
  • Underinsured patient assistance
  • Uninsured patient assistance
  • Indigent patient assistance

For more information, or to speak with a Patient Advocate Representative, call us at 888.363.7868 or email at billing@agendia.com

What is genomic testing?

Genomic tests look at your specific tumor’s genes, to help find out what’s driving its growth.  Using gene expression testing to help design a tailored treatment plan is called personalized medicine.  These are not the same as genetic tests that determine your inherited risk or hereditary predisposition for cancer.

Your physician will assess many factors prior to determining your treatment plan, including the size of the tumor, lymph node involvement, and the hormone receptor status of your cancer.  These factors, along with your tumor’s genomic profile, can help you and your physician make the most informed treatment decisions for your specific type of cancer.

Your tumor is unique, your treatment should be too

JOIN A SUPPORT GROUP

Learn more about breast cancer treatment by visiting www.knowyourbreastcancer.com or connect with a support group through the Symphony Sisterhood on Facebook