CION Cancer Clinics
Is genetic testing covered under Aarogyasri? | CION Cancer Clinics
Usually not on its own. Aarogyasri pays for listed treatment packages at network hospitals, and a stand-alone test for an inherited cancer gene fault is generally not one of them. The card can still carry much of the cancer treatment around the test. This page explains what the scheme covers, what the family usually pays, and how to check before anything is paid. At CION Cancer Clinics in Hyderabad, our oncologists review your family history with you and guide you to the right genetic counselling and testing.
On this page
- Does Aarogyasri pay for a genetic test?
- What does Aarogyasri usually cover around cancer?
- What might the family pay for the parts outside the scheme?
- How do you check with the scheme before testing?
- What the scheme usually pays, and what the family usually pays
- What this page cannot tell you
- Four things families assume about Aarogyasri and testing
- Common questions about Aarogyasri and genetic testing
The short answer
Does Aarogyasri pay for a genetic test?
Usually not on its own. Aarogyasri pays for listed treatment packages at network hospitals, and a stand-alone test for an inherited cancer gene fault is generally not one of them. The scheme can still carry much of the cancer treatment around the test, such as surgery, chemotherapy and radiation, when those fall under a listed package.
How the scheme is built
Aarogyasri is run by the Aarogyasri Health Care Trust for families in Telangana who hold an eligible ration card. It works through fixed packages. The network hospital asks the Trust for approval before treatment starts, and the Trust pays the hospital directly. Tests done as part of an approved package are folded into it.
Why an inherited gene test sits outside
An inherited gene test is usually ordered after a counselling visit, sent to a specialist laboratory and done without anyone being admitted. It answers a question about family risk as often as a question about treatment. That makes it hard to fit inside a package built around a hospital procedure, so most families pay for it themselves.
Package lists are revised. Ask the Aarogyamithra at the hospital what the current list says before you decide.Inside and outside the scheme
What does Aarogyasri usually cover around cancer?
The scheme is strong on treatment and narrow on outpatient tests. Knowing where the line falls helps the family plan.
Cancer treatment packages
Surgery, chemotherapy and radiation at network hospitals, when the treatment matches a listed package and the Trust has approved it.
Usually needed
- An active eligible ration card
- Aadhaar for the patient
- Approval before treatment starts
Tests inside a package
Scans and blood tests needed for an approved treatment are usually part of that package. A separate inherited gene test normally is not.
Employee and journalist schemes
Telangana's Employees Health Scheme and the scheme for journalists are run by the same Trust. Their rules differ, so ask the desk which scheme your family falls under.
Usually left to the family
The inherited gene test, a separate outpatient counselling visit, testing of well relatives, and courier charges for sending a sample to a laboratory outside the hospital.
Indicative cost
What might the family pay for the parts outside the scheme?
These are broad ranges seen across laboratories and hospitals, not quotes. They apply only to the parts Aarogyasri does not pay for.
A genetic counselling session
Sometimes included in the test price.
First multigene panel
For the relative who already has cancer.
Testing a relative for a known fault
Looks for the one family change only.
Indicative only. Prices vary between laboratories and change over time. Aarogyasri, CGHS, ECHS and EHS are accepted for covered treatment, and a listed treatment package costs an eligible family very differently from the figures above. Call the helpline for an estimate against your own card.
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Before anything is paid
How do you check with the scheme before testing?
Confirm the card is active
Take the ration card and Aadhaar to the Aarogyamithra desk at the network hospital. A card that has lapsed or has a misspelt name causes delays later.
Bring the doctor's note
Ask the oncologist or counsellor to write the test name, the genes and why it is needed. The desk cannot check a test it cannot name.
Ask about the current package list
Ask the Aarogyamithra whether the test falls inside any package open to you now. Ask for the answer in writing if you can.
Get a written estimate if it is not covered
Ask the laboratory for an itemised estimate in the patient's name, so the family knows exactly what it is paying for.
Ask about other help
Some laboratories and research studies offer free or reduced-price testing to families who qualify. Your counsellor will know which are open.
Keep treatment under the scheme
Paying for the test yourself does not change your treatment under Aarogyasri. Surgery or chemotherapy can go ahead through the scheme as planned.
Side by side
What the scheme usually pays, and what the family usually pays
Being straight with you
What this page cannot tell you
It cannot tell you what your card will pay for this month. Package lists, rates and cover limits are revised by the Trust, and hospitals apply them case by case. Only the Aarogyamithra at the hospital treating you can confirm the current position for your family.
It cannot tell you whether you need the test
That decision comes from your family history and your own diagnosis. It should be made with a counsellor before money is discussed, not because a scheme happens to pay for one thing and not another.
Who this does not apply to
Most people do not need an inherited cancer test at all, so for most families holding an Aarogyasri card the question never arises. This page is also about inherited testing on blood or saliva. Tumour testing used to choose treatment is a different test, covered under targeted therapy. What your specific result means is a question for the counsellor who ordered the test.
If you are unsure whether your card is active or which scheme applies, call the helpline and someone will help you check.Commonly believed
Four things families assume about Aarogyasri and testing
It pays for listed treatment packages at network hospitals. Many outpatient tests, including inherited gene tests, sit outside those packages and are paid by the family.
A package list says nothing about how useful a test is. Your oncologist or counsellor decides whether a test is worth doing, not the scheme.
It has no effect on your eligibility. Covered surgery, chemotherapy or radiation can still go through the scheme in the usual way.
The card works at network hospitals for approved packages. A separate laboratory bill for a gene test is normally paid by the family, so ask before the sample is sent.
Questions we are asked
Common questions about Aarogyasri and genetic testing
Is BRCA testing covered under Aarogyasri?
Generally not as a stand-alone test. A BRCA or panel test for an inherited fault is usually an outpatient laboratory test outside the package list. Ask the Aarogyamithra to confirm the current list, and ask your counsellor about any free programmes you might qualify for.
If the gene result changes my treatment, is that covered?
The treatment may be, if it matches a listed package at a network hospital. A result can change which operation or medicine is recommended. Whether that exact treatment is listed is a question for the scheme desk before it starts.
Can the test be added to my surgery package?
Usually not. Being admitted does not fold an inherited gene test into the package, and the laboratory bills for it separately. Arrange testing when your counsellor recommends it, rather than trying to fit it around an admission.
Is genetic counselling covered by Aarogyasri?
Consultations that form part of an approved package may be. A separate outpatient counselling visit usually is not. Some laboratories include counselling in the test price, so ask whether it is included when you compare quotes.
My mother is treated under Aarogyasri. Will my test be covered?
Your test, as a well relative, is almost always an outpatient test the family pays for. The good news is that once her fault is known, your test looks only for that one change and costs far less than hers.
How is Aarogyasri different from Ayushman Bharat here?
Aarogyasri is Telangana's own scheme and PM-JAY is the national one, and in Telangana the two run alongside each other. Neither generally pays for a stand-alone inherited gene test. The desk can tell you which scheme applies to your family.
What documents should I take to the scheme desk?
The ration card, Aadhaar for the patient, the doctor's note naming the test, and any earlier reports. If a relative has already had a gene test, take a copy of that report as well, since it can narrow and cheapen your own test.
Who can help me work out what my card will pay for?
The Aarogyamithra at the hospital treating you, working from the current package list. If you are not sure where to start, call the CION helpline with the test name and your card details, and someone will help you check.
What moves the figure
What affects the cost
Four things change the total more than anything else.
The technique used
A shaped or image-guided delivery costs more than a conventional one, and is chosen on clinical grounds rather than preference.
How many sessions
The total is driven by the number of sittings or cycles, not by a single per-visit figure.
Supporting tests
Scans, blood work and pathology done alongside treatment are billed separately.
Your cover
Aarogyasri, CGHS, ECHS, EHS or cashless insurance usually change the out-of-pocket figure substantially.
Paying for it
Insurance, schemes and payment
What you actually pay usually differs a great deal from the sticker figure.
Accreditation and empanelment
- NABH
- NABL
- ISO 9001:2015
- ArogyaSri empanelled
- CGHS accepted
- ECHS accepted
- EHS accepted
- Major cashless insurers
Meet CION's oncologists. Bring your family history or genetic report to them.
Our medical oncologists see people with a strong family history of cancer, arrange genetic counselling and testing where it fits, and plan the checks that follow.
Dr. C. Raghavendra Reddy
MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)
Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
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Where to find us
Our centres in and around Hyderabad
Addressed by landmark, because that is how this city navigates. One helpline books a consultation at any of these centres, and your team will tell you where counselling and testing take place.
Sources
- Government of Telangana — Aarogyasri Health Care Trust
- National Health Authority — Ayushman Bharat Pradhan Mantri Jan Arogya Yojana
- National Cancer Institute — Genetic Testing for Inherited Cancer Susceptibility Syndromes
- MedlinePlus Genetics — What is the cost of genetic testing, and how long does it take to get the results?
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Talk to us
Not sure what your Aarogyasri card will cover?
Tell us which test has been suggested and which scheme you hold. We will help you check what is covered and what the family would pay itself. One helpline serves every CION centre.