MaterniT21 Test

[NewEnglandLady]

Has anybody on PS had this blood test done? Anyone considering it?

DH and I are currently TTC #2 and we would both like to have this test done when I'm at 10 weeks. I plan to bring it up with my OB when I have the first (6 week) appt. once I get a BFP.

I'm an analyst married to a mathematician, so we are firmly fall into the "more information/data is better" category. When we had DD#1, they found an ultrasound abnormality at 18 weeks that was a marker for Down's and then we spent the next few days deciding whether or not to do an amnio (decided not to) and then it was a fear in the back of our heads for the rest of my pregnancy (she is perfectly healthy).

I know that the T21 test is very new, but it wasn't offered to me as an option last time (I conceived in 2011). This time around, I'd like to be more proactive and have this genetic testing done as soon as I can so that I have more definitive data than can be provided during the 12 and 18 week scans.

So for those of you who've done it, can you answer a few questions?

1. How many weeks were you when you had it done?
2. Why did you decide to do it?
3. Did your OB offer it to you or did you have to do research and bring it up to him/her?
4. Did you have any issues with insurance?

In regards to #4--I know it's $235 out of pocket, but it sounds like some people have had issues. I have a PPO, so I'm hoping that helps.

Any insight would be helpful--I feel like I'm in the minority of people who would want this test at 10 weeks and I'm hoping my OB doesn't push back.

 

[CurlySue]

Hi, NEL. I had the MT21 test, and I know a few others have as well. In case the others don't see or respond to this post, I know there is some info on the JBP thread.

I had the test at right around 10 weeks because of my age (37) and a prior miscarriage. Similar to you and your DH, the more info we had, the better we felt. Our OB had suggested it and gave us all the info we needed to get it set up with the genetic counselor.

As far as insurance goes, I wouldn't say I had any issues, but I did pay more than the $235 that had been quoted by others. I think I paid closer to $400, so a significant portion was still covered by my insurance, which was Cigna at the time.

I know testing isn't for everyone, but this gave me a tremendous sense of peace of mind and feel the cost was completely worth it for us.

 

[tammy77]

Hi NEL!

I did have the m21 at around 11.5 weeks. My OB suggested waiting past the earliest 10 because most of their data is on samples drawn at the usual 1st trimester screening. I asked for the test since I'm 36 and the jury is still our re: insurance. I was told it would be a max of $235 but my insurance has denied it so far. I'm anxious, but everything I've read has said that they'll honor the $235 even if insurance never ends up paying. So here's hoping!

Regarding results, it took about 10 days to get ours back. Everything came out clear and said it is a girl, which our anatomy scan confirmed last week! Overall, I'm really glad we had the test done, it gave us a big sense of relief. Good luck TTC #2 and hope you're bfp comes quickly!

Edited to fix wacky iPhone auto corrections.

 

[Octavia]

I'm reading this with interest because I'm also in the "more info is better" camp, but I wasn't offered this test as an option and, given DH's and my ages and our lack of any family histories of genetic issues, we decided the integrated testing (NT scan plus first and second tri blood tests) was sufficient this time around. My insurance is generally pretty good but it doesn't cover MaterniT21 so we'd have to pay out-of-pocket. I don't know what the actual cost to us would be. I'm a little conflicted about passing up the "better" test, though, so I may look into whether it's still possible (I'm 11w3d and the NT scan is scheduled for 13w). So we'll see...and if we decide to have a second child in a couple years, I'm pretty sure I would push for it at that time, since we'll be a little older and the test won't be all that new anymore either.

 

[NewEnglandLady]

Thanks to both of you for responding! It's good to know that both of your OBs were informed about it and that they were on board with you having it done without any u/s issues first.

Tammy, I've read other forums where insurance payment is a problem, but it seems like the insurer ends up paying. It's just more of a pain for some. Good luck and congrats on having a girl! I'm biased, but girls are just so darned delightful...at least until they are 12.

Octavia, frustrating that insurance doesn't cover it at all. I think the total cost is something like $2,900, but it seems like insurance always covers some portion. Most just have the $235 copayment, but some have to pay more. Still, it's better to know it's not covered than getting stuck with a several thousand dollar bill.

 

[monkeyprincess]

NEL and others, does the MT21 give more definitive results than the NT scan and the blood tests at 12 and 16 weeks? Is there a reason the MT21 bloodwork is more controversial than the other bloodwork? Just curious why insurance wouldn't cover it when there were no questions asked with the NT scan.

 

[NewEnglandLady]

My understanding is that the MT21 test is more accurate than the quad screening (including NT scan), but I also know that results are reported differently. The quad screen gives likelihood of T13, 18 and 21 results in ratios whereas the MT21 gives a positive or negative. The published figures for the MT21 test are confusing to me because they have "sensitivity" and "specificity" success rates, which (according to Wikipedia) are "statistical measures of the performance of a binary classification test". Apparently this tells you the success rate of true positives and true negatives. For T18 and T21, results are 99% accurate regardless of sensitivity or specificity, but for T13 it ranges from 91.7% - 99.7%. I have absolutely zero medical background, so I wish I could speak to this more intelligently.

My understanding is that those who get a low ratio for the quad screening often opt for an MT21 over an amnio since the MT21 is no risk and more accurate than the quad screen. Still, doctors consider both the MT21 and the quad screen as screening tests and results could only be validated through an amnio. So the MT21 is still considered less accurate than an amnio (and screens for fewer things).

In terms of why some insurance companies don't cover it, I'm not sure. I don't know if maybe it's more expensive than an NT scan/quad screen or if it's just so new that it's not worth changing their policies over. I really hope that both the NT scan and the MT21 are covered under my insurance. If I had to choose one, I'd choose the MT21 since it's more accurate from a genetic results standpoint, but I'd still like the scan because they look at other things (like potential heart defects, etc.)

 

[monkeyprincess]

Thanks for the info NEL. I'll definitely have to do a bit of reading on that when and if I get pregnant again. The results of the tests wouldn't affect our decision to keep a baby, but I am also of the mindset that is best to have as much information as possible to prepare for any potential genetic or other abnormalities.

 

[PilsnPinkysMom]

I had this test at 18 weeks, after poor results on the quad screen (for down syn.) and an inconclusive ultrasound. The doctor proposed it as a safer alternative to the amino. At the time, the test was VERY new, and insurance would cover an amino but not the MaterniT21 test. We paid $500ish out of pocket, and Sequenom (the test makers) vowed to pay the rest. They also billed our insurance, and not only did our insurance turn them down, but they drained our HRA.... Like, $1200. It took 8+ months for the whole thing to get sorted out, and in the end, Sequenom had to eat the balance.

The test gave me great peace of mind, and they drew less blood than my midwives did! If you don't mind the cost, I'd say to go for it... I may do it again, but only if my 12 week scan raises any red flags. I will bypass the had screening altogether, because it causes us lots of stress for nothing.

Eta: AMNIO, not amino. Darn auto correct!

 

[Octavia]

I just wanted to bump this thread because I was talking to my MW about this test at my appointment this morning. She said that one of the reasons it's not widespread yet is that the research hasn't come out on the accuracy of the testing for women under 35. However, she said its expected to be published sometime this fall and, in her estimation, after that happens it will become standard recommended testing for all pregnant women. Once that happens, insurance companies will start covering it. Anyway, I know that doesn't really mean much for those of us who are pregnant now, but I just thought it was interesting and wanted to share.

 

[NewEnglandLady]

PnPsMom, I'm so glad the bill finally got sorted out (and you didn't have to pay for the entire thing out of pocket).

Octavia, interesting point about the accuracy of the results for those under 35. Good to know.

I just talked with my OB about this on Friday since I had my first appt. They are actually recommending this blood screening over the traditional quad screen with the caveat that the costs are higher. The out-of-pocket cost if the test is not covered is supposed to be $800, however she said that anybody who has not been covered has called the lab and they end up covering the costs, less $200. My insurance does cover it, but if for any reason I get denied (I'm not 35, so that was my one concern), it's good to know the cost is only $200.

The way it works in my practice is that they still do the NT scan, so I still get the ultrasound. They just use this test as the genetic screening test. My fear was that I could either do this test OR the NT scan + quad screen. I really still wanted the ultrasound, so I'm glad I get the MT21 test + ultrasound.

One last thing that I didn't quite understand is the results. I thought the quad scan was a ratio (with 92% accuracy) while this test produced a positive or negative result for each trisomy (with 99% accuracy). I knew it was still a SCREENING test that wasn't 100% accurate, but my OB said it's still technically a ratio. So the results don't come back with a positive or negative for each trisomy, they still list the risk level. So the results will come back with risk levels such as "very low".

Finally, because this is done in conjunction with the NT scan, they want to draw my blood at 12 weeks. I expected that because some of the previous posters mentioned it, but I do wish I could get the test at 10 weeks. Oh well, 2 weeks is not much time at all. My OB said they'd call with the appointment time in the next week...so I guess I don't get to choose.

Anyway, just sharing what I learned at my appt. in case anybody refers to this thread in the future!

 

[amc80]

Out of curiosity, I emailed my insurance company to see if this test was covered. I was told it isn't but may be in 2014. I'm guessing/hoping/assuming that if it is covered it will be treated like any other lab work, which means no money out of my pocket. REALLY hoping it gets covered.

 

[tammy77]

Amc, hopefully they will pay for it! I'm AMA but my insurance gave Sequenom the run around on it for several months. I just got notification though that they finally paid the bill, at least most of it. The total they paid was $2,100 so I doubt I'll be billed for any additional amount. Phew!