SF D.
For expectant fathers: do not use your insurance!
I am expecting my first child (I am the father). My doctor ordered an expanded genetic test based on genetic counseling. The test involved a simple blood draw and I received the results in under two weeks. The test revealed I was a carrier of a rare recessive autosomal condition that is not life-threatening. Ultimately this was moot because my partner, who also ordered the same test, was negative for every gene on the panel. I was grateful to have this information, and the AI assistant offered by Natera helped me make sense of the result. Its characterization of the risks to my child were accurate and perfectly consistent with what our doctor told us later. As it turns out, however, the test was unnecessary: if the mother has negative findings across all genes on the panel, there is arguably no need for the father to take the test at all. Our doctor did not communicate this to us, but as it turns out, that is precisely the view taken by my insurer, and probably most major insurers. As for billing, I have allegedly excellent health insurance: a Blue Cross / Blue Shield PPO. My doctor requested pre-authorization, but I was unaware of this and contacted my insurance directly before agreeing to the test. The answer I received on the phone was that the test was very likely covered but that it would cost approximately $1,070, which would be all out of pocket because I had not reached my deductible. Natera, on the other hand, said that the test would cost $349 if I paid directly without going through insurance. I obviously chose to pay directly and my total cost was $349. Several weeks later, after I had already received the results, I received a letter from a consultancy hired by Blue Cross / Blue Shield to evaluate coverage decisions, and the letter said the test was deemed medically unnecessary and that coverage was denied because there was no research to support that most of the genes on the test would impact MY medical needs (that is emphatically not the point of a genetic screening test during pregnancy, but whatever). This letter referred me to a webpage listing the source it cited as an authority. That page contained explicit guidance that an expanded genetic panel was considered medically necessary for any individual considering reproduction who had certain ethnic backgrounds, including my own. So to recap: my doctor ordered the test after genetic counseling based on her professional medical opinion; a direct call to my insurance suggested the test was very likely covered; and the authority cited in a printed letter affirmed that I met the criteria for the test to be considered medically necessary. And despite all this, Blue Cross / Blue Shield denied coverage. Even though I didn't ask them to cover anything. I am sharing this information so that other expectant fathers considering a Natera test understand that paying Natera directly is almost certainly a much better option than trying to go through insurance, which cannot be relied upon to adhere to medical research or even their own published authorities. Doing so saved me at least $700, not to mention the hassle of an appeal process that, judging by the processes I've described here, was likely to be fruitless. I evidently have been paying Blue Cross / Blue Shield hefty monthly premiums just to have them negotiate a price 3X what I would pay if I were uninsured (or pretended to be uninsured), and to deny coverage anyway on completely spurious grounds. Part of this grift is on Natera, too, which engages in the sort of price discrimination that is rampant in health care. Obviously the $349 price tag encompasses the full cost of the test as well as a healthy profit margin for Natera; charging my insurer $1070+ for the same test is literal price gouging, and it is indefensible. The scam is only possible because the average patient lacks the time, resources, or know-how to ask the questions I chose to ask. Hopefully this testimony will help others.
Response from NateraSep 7, 2026
Thank you for taking the time to share this thoughtful feedback. We work to ensure patients can access our products and seek to remove financial barriers wherever possible. If further assistance is needed, please reach out to [email protected]. Thank you.