Costs, Insurance & Financial Assistance
Genetic testing without the billing anxiety.
You should never be blindsided by a bill for a test your doctor recommended. We built our billing process to make sure that doesn’t happen.
Most Patients are Covered
Our tests are recommended by national guidelines and covered by most commercial plans.
We Check Before We Bill
We verify your coverage and contact you to discuss options if your costs look high.
Flexible Assistance Options
Financial assistance programs are available for qualifying individuals.
Every test we offer is recommended by national clinical guidelines and supported by decades of evidence. Most insurance plans cover them for eligible patients. The challenge has always been opacity in the billing process, and we’ve rebuilt that process from the ground up.
What to Expect, Step by Step
Your clinician orders a test
Your doctor or genetic counselor places an order with Arboretum. That’s all you need to do to get started.
We verify your insurance
Our system automatically checks your benefits, confirms your plan is active, and estimates your out-of-pocket cost.
We reach out if costs are high
If your out of pocket costs with insurance look high, we contact you within three business days to discuss options: either bill insurance, or pay a cash rate for the test. Cash rates are as low as $250 per test.
You choose your billing path
Use insurance or pay cash. We document your choice and move forward.
We handle billing and keep you in the loop
Once decided, we process your sample and bill according to your choice.
If an insurance claim is later denied or your estimated cost changes, we work with you on next steps before sending you a bill. If insurance leaves a balance, our Financial Assistance Program may be able to help.
State laws protect you
While most insurance plans already cover our tests, a growing number of states now require health insurers to cover biomarker and genetic testing when it’s medically appropriate. These mandates generally apply to state-regulated health plans.
Sixteen states currently have laws mandating coverage for biomarker or genetic testing: twelve (AZ, CO, FL, GA, IL, KY, MD, MN, NM, OK, RI, TX) cover all medical conditions, and four (AR, CA, LA, NV) cover cancer-related testing specifically.
Patient Assistance Programs
We never want cost to prevent you from getting a test your doctor recommends. Our flexible assistance options can reduce patient cost and billing uncertainty.
Cash Pay
For patients who do not have insurance, whose plan does not cover the test, or whose out-of-pocket costs through insurance would be unaffordable, you can pay our cash rate instead. Because this option bypasses insurance entirely, it cannot be combined with insurance billing.
Financial Assistance Program
If your insurance covers the test but your remaining out-of-pocket cost is higher than expected, our Financial Assistance Program may reduce what you owe. The program factors both your income and financial hardship you may be experiencing, and applies to balances left after your insurance has processed the claim. For those that qualify based on income alone, your remaining balance may be capped at $175, $100, or $0. Those that qualify based on financial hardship are eligible for % discounts off of your bill determined by your unique situation.
Charity Care Program
For patients without insurance coverage that also have financial hardship, charity care may fully waive the cost of testing. Talk to your provider or contact our billing team to learn more.
Financial Assistance Application
Our application includes a guide for federal poverty level limits and discounts for those who meet income criteria.
To Apply
Submit a completed Financial Assistance Application along with supporting documentation to billing@arboretumclinical.com
Applications are reviewed within 10 business days. Assistance can be applied retroactively to outstanding balances.
Frequently Asked Questions
Will I get a surprise bill?
Our entire process is designed to prevent this. We estimate your out-of-pocket cost before the test runs, and contact you if it looks high. Insurance decisions can occasionally change after a claim is processed, but if that happens, we reach out to discuss your options, including financial assistance, before sending a bill.
What if my insurance denies the claim?
Denials are rare because we verify coverage upfront and only submit claims with a clear path to payment. If a denial occurs, we review whether to appeal and communicate with you along the way before sending a bill.
What does a test cost if I pay cash?
Our cash-pay rates start as low as $250 depending on the test.
What insurance plans do you accept?
We bill virtually all insurance plans that provide coverage for our tests. We verify benefits for every order, so you don’t need to guess whether your plan works with us.
Can I apply for financial assistance after I’ve already received a bill?
Yes. You can apply at any time, including after receiving a billing statement. Assistance can be applied retroactively to outstanding balances.
Can my doctor apply for financial assistance on my behalf?
Yes. Your physician or their staff can submit a Financial Assistance Application through our ordering portal.
Questions?
Our billing team is here to help you understand your coverage, your options, and your costs before anything happens.
Call: 617-465-0969
