• I have private health insurance

  • I have Medicare/Medicaid

  • I don’t have medical insurance

  • Most private insurance carriers cover the tests for eligible patients
  • Exact Sciences is an in-network provider with many health plans, including Aetna, Anthem, Cigna, Humana, and UnitedHealthcare
  • Exact Sciences performs the services ordered and deemed medically necessary, regardless of network provider status

† Genomic Health, Inc., an Exact Sciences company, is the billing entity for Oncotype® and Oncomap™ tests.

  • Medicare covers the tests for eligible patients
  • $0 financial responsibility when Medicare fee-for-service (FFS) coverage criteria are met

Exact Sciences offers financial assistance for patients without health insurance or who are facing financial hardship. See if you qualify using the Financial Assistance Estimator.

Financial Assistance Estimator

Financial assistance is available for eligible patients who are uninsured and may be available for insured patients unable to pay the out-of-pocket amount determined by their insurance. See if you could be eligible for testing at no cost with the Financial Assistance Estimator.

Complete the following fields and submit:

Patient State*
Patient State must be filled in
Household Size*
Household Size must be filled in
Annual Income*
Annual Income must be filled in
Submit

Exact Sciences may modify or terminate its Genomic Access Program (GAP) and/or financial assistance options at any time. If you live in American Samoa, Guam, the Northern Mariana Islands, Puerto Rico, or the US Virgin Islands, please contact Customer Service at 888-ONCOTYPE (888-662-6897), option 2 to discuss available financial resources.

*Genomic Health, Inc., an Exact Sciences company, is the billing entity for Oncotype tests.

Patient Qualification:

 You qualify for financial assistance

Based upon the information provided you could have no out-of-pocket costs for this test.

Please note that additional information is required to apply:

 

1

Download the Financial Assistance Disclosure and Application Form
Download application in Spanish

2

Complete and submit the form along with required supporting documentation

3

Exact Sciences will review your completed application and confirm eligibility

Download the Application

Patient Qualification:

 You do not qualify for financial assistance

Based upon the information provided, the financial assistance criteria have not been met.

However, Exact Sciences offers flexible payment options and can discuss any extenuating circumstances the patient may have.

Contact Customer Service at 888-ONCOTYPE (888-662-6897), option 2 to discuss further.

Contact Customer Support

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Partnering with you through the Genomic Access Program (GAP)

To support you even more, Exact Sciences created the GAP—a comprehensive program designed to help you navigate and understand the insurance and billing process for the Oncotype tests. The GAP assists with obtaining prior authorizations, billing insurance, appealing denied claims, and providing flexible payment options when necessary. Please call 888-ONCOTYPE (888-662-6897), option 2, for more information on insurance and for financial assistance questions or download the GAP guide.

What to expect after your doctor orders your genomic test

1Exact Sciences bills your insurance once testing is completed.

2You will receive an Explanation of Benefits (EOB) from your insurance.

An EOB is not a bill or an invoice.

3In many cases, patients have little to no out-of-pocket costs for the test.*

4If your insurance denies payment, Exact Sciences will pursue appeals on your behalf where appropriate.

You may be asked by Exact Sciences for authorization to pursue an appeal with your insurance company.§

5See more billing information specific to your insurance coverage

Learn more

Billing FAQs

* This calculation includes patients with Medicare, Medicare Advantage, Medicaid, Managed Medicaid, and commercial insurance. Patient cost-sharing amounts, including deductibles and copays, will vary by plan and coverage type. Only your patient’s insurer can confirm if and how the Oncotype DX test will be covered.

† Genomic Health, Inc., an Exact Sciences company, is the billing entity for Oncotype® and Oncomap™ tests.

§ In some cases, consent to appeal is required. If your insurance company requires consent for Exact Sciences to appeal on your behalf, we will contact you. It is important to sign and return consent forms as soon as possible to allow timely appeals in case the claim is denied.

We’re here to help

Let the Exact Sciences Customer Service group help you with Medicare coverage, private insurance coverage, and financial assistance.