Genetic Testing

Aetna covers disease-specific genetic testing to establish a molecular diagnosis only when the member has compatible clinical features or is at direct risk, the test result will directly impact management, and after history/exam, pedigree analysis, genetic counseling and conventional diagnostics a definitive diagnosis remains uncertain with disease‑specific criteria met. Covered examples include APC testing for >10 colonic polyps or affected first‑degree relatives (with family mutation identified if feasible), AR sequencing for suspected androgen insensitivity or targeted carrier/prenatal testing, Angelman methylation/UBE3A testing per algorithm, and comprehensive ARVD/C panels for those meeting Task Force criteria, while testing outside these listed indications (including general‑population AIS carrier screening, many other APC uses, expanded CF panels beyond the ACMG panel, and numerous other disease‑specific tests) is considered experimental/investigational.