Ambry's Health Plan Guide for

Health Plan:
(Plans with * are Not Enrolled/Not Contracted)

Test Name:

Covered?

${ getPlanData(plansOne + testsOne, 'covered') }

${ getPlanData(plansTwo + testsTwo, 'covered') }

${ getPlanData(plansThree + testsThree, 'covered') }

${ getPlanData(plansFour + testsFour, 'covered') }

${ getPlanData(plansFive + testsFive, 'covered') }

Forms / Documents Required:

${ getPlanData(plansOne + testsOne, 'authorization') }

${ getPlanData(plansTwo + testsTwo, 'authorization') }

${ getPlanData(plansThree + testsThree, 'authorization') }

${ getPlanData(plansFour + testsFour, 'authorization') }

${ getPlanData(plansFive + testsFive, 'authorization') }

Pre-test Counseling Required:

${ getPlanData(plansOne + testsOne, 'counseling') }

${ getPlanData(plansTwo + testsTwo, 'counseling') }

${ getPlanData(plansThree + testsThree, 'counseling') }

${ getPlanData(plansFour + testsFour, 'counseling') }

${ getPlanData(plansFive + testsFive, 'counseling') }

Other Considerations:

${ getPlanData(plansOne + testsOne, 'documentation') }

${ getPlanData(plansTwo + testsTwo, 'documentation') }

${ getPlanData(plansThree + testsThree, 'documentation') }

${ getPlanData(plansFour + testsFour, 'documentation') }

${ getPlanData(plansFive + testsFive, 'documentation') }

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