Insurance Coverage & Financial Assistance

Medicare and the majority of private insurance carriers cover the Oncotype DX Breast Recurrence Score test for eligible patients with early-stage invasive breast cancer. Since insurance coverage can vary across the country, it’s a good idea to check with your carrier.

Out-of-pocket costs for the Oncotype DX Breast Recurrence Score test, if any, are determined by the insurance company. You may have financial responsibility for a co-pay, co-insurance, deductible or non-covered charges as determined by your insurance plan once available appeal options are completed. The numbers* cited below are based on historical patient billing data:

86% of Oncotype DX Breast Recurrence Score test patients have $0 financial responsibility
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 insurer can confirm if and how the Oncotype DX Breast Recurrence Score test will be covered.
91% of Oncotype DX Breast Recurrence Score test patients have a financial responsibility of <$100
This calculation includes patients with Medicare, Medicare Advantage, Medicaid, Managed Medicaid and commercial insurance. Patients with high-deductible plans may receive a bill for most or all the cost of the Oncotype DX Breast Recurrence Score test if they have not satisfied their deductible.

* The numbers cited are based on historical patient billing data from 1/2/2021 to 12/31/2021. Rates of coverage vary by state and region. Exceptions for coverage may apply. Exact Sciences strongly encourages you to contact your insurer with questions about Oncotype DX Breast Recurrence Score test coverage.

Genomic Access Program

Exact Sciences believes that everyone should have access to the information they need to make confident, informed decisions about their cancer treatments. To ensure you can focus on your health, Exact Sciences created the Genomic Access Program (GAP), which helps eligible patients determine payment options for our tests. We work with providers, patients, and insurance companies to investigate coverage and complete any prior authorization requirements, where applicable.

If you have insurance, Exact Sciences will bill your insurance once testing is complete. In the event your insurance denies payment, Exact Sciences may contact you to complete a consent form that allows us to pursue an appeal on your behalf. If you don’t have insurance, our Customer Service team is available to help you manage the cost of testing.

Download the GAP Brochure
Download in other languages: Spanish | Traditional Chinese | Simplified Chinese

To discuss our flexible payment options, your extenuating financial circumstances, or to be pre-screened for financial assistance, contact Customer Service by phone at 866-ONCOTYPE (866-662-6897, option 2) or message us for more information.

Financial assistance

Exact Sciences offers financial assistance for eligible patients based on the Federal poverty guidelines. If eligible, both insured and uninsured patients will have no out-of-pocket costs.

 

For more information, see our FAQs

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