The vast majority of diseases are multifactorial, i.e. It is hard to predict if an individual will fall sick or die in a given year. Also in August, 2015 the Canadian Life and Health Insurance Association (CLHIA) developed an Industry Code as part of its updated position on how genetic test results are used in risk selection and insurance underwriting. What kinds of direct-to-consumer genetic tests are available? Passed in 2008, a federal law called the Genetic Information Nondiscrimination Act (GINA) made it illegal for health insurance providers in the United States to use genetic information in decisions about a person's health insurance eligibility or coverage. If yes, consider applying for new coverage and terminate the existing one after the new policy has been issued and accepted. Private information, according to the OPC's privacy criteria, should only be collected if it can be shown that it is necessary for legitimate business purposes and efficient in accomplishing the task for which it is used. This motion does not specifically address the use of genetic testing  by insurance companies but "all forms of discrimination" could be construed to include the use of genetic information in the establishment of insurance rates and acceptability although, as you will read below, similar wording in the USA has not been applied to all insurance.​​. It maintains that there is little evidence to believe that results of genetic tests will result in significant antiselection. Can a direct-to-consumer genetic test tell me whether I will develop cancer? It could affect a patient's eligibility for insurance or result in a significant increase in their insurance premium. What are secondary findings from genetic testing? What are the benefits of genetic testing? The common practice in the industry is to ask for new applicants to submit results of genetic tests only if they have already gone through such tests. With the existing knowledge and technology, the contribution of multiple genes, relative to other factors, in causing an illness cannot be established accurately. However, GINA does not cover life insurance, disability insurance or long-term care insurance. That’s right — home DNA tests reveal more than just your ethnicity. This means that health insurance companies cannot use the results of a direct-to-consumer genetic test (or any other genetic test) to … Above these amounts, insurers can only use test results if the test, the disease, and the product have been approved. The study also concluded that the rates for traditional permanent insurance would also rise but to a lesser extent than term insurance. According to the OPC, this can be validated by insurance markets in countries that have legislations prohibiting the use of known genetic test results. An insurer that does not know about the applicant's genetic test results would issue the increased coverage, without realizing the high likelihood of an earlier claim. In the absence of pools, lower-risk individuals would subsidize higher-risk individuals via higher premiums. This behaviour of selecting against the insurer due to information asymmetry is often referred to as "anti-selection". Insurers often require applicants to disclose their family's health history as a means to assess risk. The Canadian Human Rights Act and provincial human rights codes are potentially relevant to the extent that they prohibit discrimination or discriminatory practices on the basis of disability, age, sex, race and other enumerated grounds. A number of factors are considered for pooling individuals, such as age, smoking status, existing illnesses, etc. The OPC maintains that insurers already have access to health information, including family history, and are able to price insurance products just as effectively as they would if they also had access to genetic information. Genetics, and in particular genetic testing, has seen significant advances since the completion of the Human Genome Project in the 1990s, an international scientific research effort that produced the mapping of the full sequence of human genes. What does it mean to have Neanderthal or Denisovan DNA? How much does direct-to-consumer genetic testing cost, and is it covered by health insurance? The resources on this site should not be used as a substitute for professional medical care or advice. What is circulating tumor DNA and how is it used to diagnose and manage cancer? ​However, hand in hand with this promise is the potential to use genetic information to discriminate against someone. If you are interested in learning more about the relevance and use of genetic information within the insurance industry and the arguments both for and against the collection of such personal information, keep on reading.​. Genetics Home Reference content now can be found in the "Genetics" section of MedlinePlus. You should weigh the possible benefits and risks of direct-to-consumer genetic testing, including potential impacts on insurance eligibility and coverage, before you start the testing process. How do direct-to-consumer genetic testing companies protect their customers’ privacy? Some companies have used genetic screening and/or genetic monitoring of employees and job applicants for research and other undisclosed purposes. Genetics Home Reference content now can be found in the "Genetics" section of MedlinePlus. Under GINA, it is unlawful for health insurance companies to request or require an individual to complete a genetic test or purchase genetic information for liability purposes.¹ Health insurance companies are only permitted to request genetic results to verify the necessity of a procedure or treatment that has been billed; in that case, they are allowed to have minimal information to know … What do the results of genetic tests mean? If you want to undergo genetic testing but fear that the results might have a negative impact on your insurance eligibility, here is a recommended approach: If you have undergone genetic testing already, you will need to disclose the results to the insurers if they ask for them. Can the results of direct-to-consumer genetic testing affect my ability to get insurance? GINA does not apply to other forms of insurance, such as disability insurance, long-term care insurance, or life insurance. Genes In Life discusses insurance coverage and reimbursement for genetic testing. People considering genetic testing may want to find out more about their state's privacy protection laws before they ask their insurance company to cover the costs. Most American states have similar laws. A person interested in submitting the costs of testing may wish to contact his or her insurance company beforehand to ask about coverage. For example, if you are in good health but were assigned to an average risk group due to family history of heart disease, genetic test results that show that you to be a better than average risk could help you get lower premiums on another policy. Though it remains to be seen to what extent this assumption is true, there has been at least one attempt to quantify the cost of banning insurers access to the known results of genetic tests. As discussed above, genetic testing could have broader implications than medical diagnosis. The argument presented above is predicated on genetic tests providing information that is substantially different than what insurers can already establish through family history. Will health insurance cover the costs of genetic testing? GINA keeps health insurance companies and employers from discriminating on the basis of information that might be found in a genetic screening. Coverage and Reimbursement of Genetic Tests. Users with questions about a personal health condition should consult with a qualified healthcare professional. Check whether or not test results allow you to get a better deal than your existing policy. Insurance is an exercise in "pooling" together individuals that are likely to exhibit similar financial risk in the future.