Coverage Counts

Learn why more and more health plans are saying “yes” to our tests

Providers & Administrators

Broad coverage makes our tests more accessible to a greater number of patients.

Search your state's coverage

Health Plans & Benefit Managers

1000+ peer-reviewed publications and 50+ FDA-approved CDx indications make covering our full portfolio an easy decision.

View Evidence Portfolio

National health plans cover our comprehensive genomic profiling (CGP) tests

Foundation Medicine's coverage is continually changing and expanding. Patients should reach out to their individual health plans to verify their benefits and qualifying medical criteria, as those details are not represented on this diagram.

Patients who have out-of-pocket costs associated with testing and a financial need may apply for assistance by completing the online form at aid.foundationmedicine.com. Patients may apply at any time, even before testing. If approved, qualifying patients will only pay up to $100 for each test. Financial assistance decisions will be shared with patients within days after their application is received.

See who covers our tests in your state

or view our list of in-network health plans

Select

  • Aetna
  • Blue Cross and Blue Shield Federal Employee Program
  • Centene Corporation
  • Cigna Health Plans
  • Elevance Health, operating as Anthem Blue Cross Blue Shield
  • GEHA (for federal employees)
  • Humana
  • Medicare
  • Medicare Advantage
  • Tricare
  • United Healthcare
  • Veteran's Association/VA Community Care Network

Foundation Medicine's coverage is continually changing and expanding. Patients should reach out to their individual health plans to verify their benefits and qualifying medical criteria, as those details are not represented on this diagram.

Patients who have out-of-pocket costs associated with testing and a financial need may apply for assistance by completing the online form at aid.foundationmedicine.com. Patients may apply at anytime, even before testing. If approved, qualifying patients will only pay up to $100 for each test. Financial assistance decisions will be shared with patients within days after their application is received.

Anthem and other national payers cover our portfolio of CGP tests
100+ in-network health plans across the country
Medicare, Medicare Advantage, and TRICARE cover our portfolio of CGP tests
80+ regional and national commercial health plans cover our testing
UnitedHealthcare covers our FDA-approved tests

Evidence of medical necessity: the key to securing coverage

Foundation Medicine has 1000+ peer-reviewed publications. We also have 50+ FDA-approved CDx indications >60% of all approved US companion diagnostic (CDx) indications for NGS testing.

 

Download our evidence portfolio

  • Testing informs treatment

    Our tests match specific biomarkers to clinical trials and FDA-approved therapies

  • Performance drives approvals

    Tests with proven accuracy and reliability receive FDA approvals and companion diagnostic indications

  • Efficacy builds trust

    Medical necessity gives payers the confidence to cover our full portfolio of tests

Watch the video

Foundation Medicine believes every person with advanced cancer can benefit from precision medicine—and that CGP testing should be accessible to all. Learn how we're making that happen.

Broad coverage drives equitable access to CGP testing

When CGP testing is more accessible, biomarker-matched therapies and clinical trials are too—a potentially life-changing opportunity for people with advanced cancer. And with coverage by 20+ state Medicaid plans, we're helping vulnerable patients access the care they need.

Included with every one of our CGP tests: Patient and provider support

Patients spend less time on billing

Our FoundationAccess® program is here to walk patients through the coverage and billing process—and provide information about financial assistance.

  • After receiving a test order, we review your patient's plan to see what's covered. If we expect an out-of-pocket cost, we contact your patient to let them know.
  • Any patient can apply for our needs-based financial assistance at any time—even before testing is ordered. All that your patients need to do is complete a simple form.

 

Direct patients to apply online

$0

paid by qualifying state medicaid patients

nearly

9/10

patients owe $0 for testing*

up to

$100

out-of-pocket maximum per test for patients who qualify for financial assistance

*Data on File, Foundation Medicine, Inc., 2023. Based on US settled claims for FoundationOne®CDx, FoundationOne®Liquid CDx, FoundationOne®Heme, and PD-L1 IHC ordered from Foundation Medicine, reported between 1/1/22 and 3/31/23 before considering any financial assistance. 65% of commercially insured and 96% of Medicare and Medicare Advantage patients owe $0 for Foundation Medicine testing.

You spend more time with patients

CGP testing doesn't have to be hard. With Foundation Medicine, it isn't.

  • When allowed, we and our partner Glidian can support you with prior authorizations, helping reduce the time you spend on them.
  • Get timely CGP test results in a way that complements your workflow—via email, portal, or right in your EMR.

Frequently asked questions

Contact a coverage expert today

We want to make accessing a Foundation Medicine test as easy as possible for you and your patients. Tell us how we can help.