Certain health issues and medical conditions are hereditary, which means that genetic testing can reveal markers and signs of these issues before symptoms arise. Genetic testing can also give physicians an opportunity to make an early diagnosis for chronic symptoms, and can help your health care team design a targeted treatment plan.
Common Types of Genetic Testing for Adults
Because human DNA is so complex, the development of genetic tests is ongoing and new discoveries of how to apply testing to the diagnosis and treatment of disease are made frequently. Due to the still-incomplete understanding of the human genome, many of these tests remain in an experimental trial phase.
Mainstream genetic testing for adults covers a wide range of conditions. These are typically categorized by the function they serve:
- Diagnostic, predictive or presymptomatic. Patients who seek out these tests may already experience symptoms of a disease or, absent any symptoms, may know they have a family history of certain hereditary conditions. A genetic test can confirm or rule out an appropriate diagnosis. Examples of diseases that can be hereditary and confirmed by a genetic test include polycystic kidney disease (PKD) or hemochromatosis. Genetic testing can also reveal markers for many types of cancer, though it does not determine a certainty that the patient will develop that type of cancer.
- Carrier. Though a person may never develop a condition or symptoms related to it, they may be a genetic carrier for that condition. A test that looks for genetic markers that indicate a person is a carrier of a hereditary disease can help them know whether they could pass or have already passed this gene down to a child if the other parent is also a carrier.
- Pharmacogenomic. The study of genetics plays a major role in learning how the body metabolizes or reacts to certain medications. In some cases, a person’s genetic makeup can show whether a certain treatment will be effective or if it will cause an adverse reaction. This can help physicians target their treatment plan accordingly, which can improve the chances for successful outcomes for the patient’s health and recovery.
Many non-medical genetic tests exist that are used to help determine identity or genealogy. These may be available as an over-the-counter product but are not used to serve as any diagnostic resource to determine medical conditions or treatment options.
Risks and Limitations Associated with Genetic Testing
Most genetic tests for adults have very few risks and may be as simple as swabbing the inside of a patient’s cheek. Other tests may require a blood sample, which may mean a patient experiences common side effects related to blood being drawn. This may include redness or irritation at the site of injection.
Depending on the severity of the situation, there can be an emotional or behavioral impact related to genetic testing. This may be during the process of assessing the need for a genetic test, waiting for results, or upon receiving a positive diagnosis of a genetic condition.
Genetic tests may be able to determine the presence of genetic markers associated with hereditary conditions, but these do not reveal how likely it is for a person to develop the disease or how symptoms may vary or progress. The health care professional performing the genetic test can explain any limitations known for a specific test and its common uses.
Medicare Coverage for Genetic Testing
In order for Medicare to cover genetic testing, certain requirements must be met. These can change each year, which means recipients should check with their Medicare providers to verify the tests they need remain covered. Medicare Advantage plans that offer extra benefits may extend the types of genetic tests covered, but these additional benefits vary from plan to plan.
Medicare Part B may cover genetic testing when a recipient shows symptoms of medical conditions that have FDA-approved genetic tests developed for diagnosis. This may not include all genetic tests that fall under this category if the recipient’s condition is not considered severe or if the recipient does not intend to pursue treatment indicated by the genetic test’s results.
Additionally, Medicare may cover certain tests that help determine a patient’s response to medications when a physician deems it medically necessary or after trying other medications is not successful.
Does Medicare Cover Genetic Counseling? (Opens in a new browser tab)
Does Medicare Cover a Second Opinion? (Opens in a new browser tab)