He is almost 21 years old, and was diagnosed at age 4 after a muscle biopsy. In the last year, he was diagnosed ASD.
I am so sorry to hear of your family, and son's unfortunate circumstances.
In review of your specific benefit plan, eligible services are payable at an 80% coinsurance level following your $2800 deductible being met. There is a $5000 maximum out of pocket.
Here is the link to our coverage policy.
Medical and Pharmacy Coverage Policies - Search Results
Some genetic testing services do require prior authorization. In this instance, your referring provider would contact our Clinical Intake team at 800 - 523 - 0023.
Best wishes to you and your family.
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