Genetic Testing for Cardiac Disease – Commercial and Individual Exchange Medical Policyopen_in_new

UnitedHealthcare covers multi-gene panels (≥5 genes) as medically necessary for diagnosis/cascade testing of specified inherited arrhythmias (Brugada, CPVT, LQTS with acquired causes ruled out and specified ECG/clinical criteria, SQTS), cardiomyopathies (ARVD/C, HCM, DCM without identifiable cause with conduction disease or family SCD ≤45, LVNC) and inherited thoracic aortic disease (affected individual or first/second‑degree relative), but considers genetic testing for coronary artery disease and other cardiac genetic tests not listed here unproven and not medically necessary (chromosome microarray for isolated severe congenital heart disease is an exception). Coverage requires documentation of the diagnosis/family history and any required rule‑outs (e.g., acquired causes for LQTS), pre‑test genetic counseling is strongly recommended, and benefit is subject to member‑specific plan terms and medical record review.

"Pre-test genetic counseling is strongly recommended in order to inform persons being tested about the advantages and limitations of the test as applied to a unique person. Multi-Gene Panel testing ..."