We’re reaching out to make sure you’ve received information about our cutting-edge whole genome sequencing (WGS) coverage, with the goal of more quickly identifying and diagnosing genetic conditions in children with complex cases and improving patient outcomes. This coverage is available for eligible members of Harvard Pilgrim commercial plans and Tufts Health Commercial and Public Plans.
By analyzing entire genomes and delivering a large volume of data in a short time, WGS is able to identify large and small variants that might be missed with targeted approaches. Harvard Pilgrim and Tufts Health Plan are making this leading-edge precision medicine technology available for the appropriate patients through an agreement with Illumina, Inc. We’re delighted to offer this technology to members as it can potentially save them from a long, costly diagnostic odyssey that often results in enormous frustration, heartache, and financial challenges.
WGS is covered for members under age 18 in outpatient settings with prior authorization. Genetic counseling is required, and the testing must be requested by an independent medical geneticist, genetic counselor, or genetic nurse.
Requesting Authorization
To request authorization for WGS for Harvard Pilgrim members, providers should contact AIM Specialty Health in one of the following ways:
