Currently, most insurance contracts state that they will cover procedures that are "medically necessary," which include those involved with diagnosis or treatment of an illness, injury, or pregnancy. Traditionally made by doctors on the basis of medical examinations, diagnoses of genetic disorders can be made earlier using genetic screening. The condition could then be treated although it is not yet present in the patient.

In 1994, The Supreme Court of Nebraska ruled that a woman's insurance company must pay for her total abdominal hysterectomy, since her family had a history of gynecological cancers and she herself had a 50% risk of developing ovarian or breast cancer. The Court ruled that the insurance company was bound to cover the surgery since the procedure would eliminate or greatly reduce her chances of developing gynecological cancers; it was, in the Court's eye, "medically necessary."

Insurance coverage is presently based on age, gender, race, and medical history. A problem arises when it must be decided whether results of genetic screening should be included in an individual's medical history.

Currently, levels of risk are established using the same criteria used to determine who can receive coverage and who cannot. However, insurance companies feel that results of genetic testing should be provided as part of a patient's regular medical history. This would definitely result in discrimination against those who test positive for late-onset genetic disorders including cancers and heart disease.

Rates will increase to compensate for high-risk patients. This may result in many younger people going without coverage because they cannot afford it.