Insurance Coverage & Financial Assistance

Exact Sciences believes that everyone should have access to the information they need to make confident, informed decisions about their cancer treatments. Through GAP, Exact Sciences takes every possible step to ensure testing is affordable, available, and accessible. That's why Exact Sciences created the Genomic Access Program (GAP), which helps eligible patients navigate insurnace and other payment options. Contact Customer Service by phone 888-ONCOTYPE (888-662-6897) or by email.

Insurance coverage

Medicare now covers the Oncotype DX AR-V7 Nucleus Detect test for patients with metastatic castration-resistant prostate cancer. If your private insurance covers the test, our GAP team will:

  • Work with your physician to get prior authorization from your insurance company (if required).
  • Bill your insurance directly when possible.
  • Process the claim once the test is complete.
  • .
  • Assist in the review process if a claim is denied.

To get started with GAP, contact Customer Service or call us with your questions.

Financial assistance

Exact Sciences offers financial assistance programs for eligible patients with financial hardship. These programs are based on financial eligibility. Contact Customer Service by phone at 888-ONCOTYPE (888-662-6897) or via email for more information.

The Medicare 14-Day Rule

Exact Sciences Corporation (Exact) is committed to compliance with all applicable laws, rules and regulations, including billing regulations promulgated by the Centers for Medicare and Medicaid Services (CMS). When a laboratory test such as Exact’s OncoType Dx® test is ordered for a hospital inpatient within 14 days of the patient’s discharge from the hospital, CMS regulations require Exact to bill the hospital directly for that test. This rule is commonly referred to as the “14-day rule.” The 14-day rule is part of CMS’ Date of Service Regulation (42 C.F.R. Section 414.510). As of January 1, 2018, the 14-day rule does not apply to tests ordered for hospital outpatients, and Exact bills Medicare directly for such tests, regardless of their order date.

Exact processes test orders as they are received from ordering providers. Clinical judgment should be the determining factor regarding when tests are ordered and Exact does not seek to influence the timing of test orders for any given patient due to billing or other reasons.

Making cancer care smarter.®