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Are prenatal paternity test covered by insurance?



More and more we rely on insurance to cover unforeseen expanses. The cost of a prenatal paternity test can be significant for most families. Naturally many of our clients wonder if their workplace health insurance, or private insurance will reimburse the cost of a prenatal paternity test. At DNAForce, we have contacted most major health insurance provider to ask them this question.

Here is the response that we have received from Wendy Hope the vice-president of external relations at the Canadian Life and Health Insurance Association Inc which is one of the largest insurance organization in Canada. Her response is:"

Your enquiry regarding coverage by insurance companies of prenatal paternity tests was forwarded to me. Generally, to be considered for coverage under most benefit plans, the lab test would need to be medically necessary i.e., to diagnose and determine a course of treatment. In this case, since the test would be the member's choice and not to achieve either objective, it typically would not be covered. However, it is possible that some Health Care Spending Accounts, which some plan sponsors offer as part of their benefit package, may provide for reimbursement of these tests. Employees should check with their employers (plan sponsors). Best regards,

The response is reflective of the state of the insurance industry at the moment. The prenatal paternity test is not a medical diagnostic and it is not ordered for a recognized medical purpose. The test is scientifically accurate but it is done to establish paternity. As recommended by Wendy Hope, if you take part on a Health Care Spending Account, you should follow up with your provider and ask them this question.

In you request it, DNAForce will provide you will all the paperwork that you need for you to ask for a reimbursement.