I just got back from my 12 week prenatal appointment and was asked what type of genetic testing I wanted to do. California offers to all moms-to-be the expanded AFP screening (also known as the triple screen) that checks for Downs, trisomy 18 and neural tube defects. This is free, as are any follow up diagnostic tests. The nurse also told me about the integrated screen. This test is more accurate (info page says the Integrated Screening has higher detection rate for Downs 88% vs. 60%, reducing the chance that a Down syndrome pregnancy is missed and decreasing the chance of a false positive result compared with the AFP screening). This test also includes an ultrasound in the first trimester that measures the nuchal translucency and measures an additional protein. This tests cost about $600. Im 33 and since I dont have a family history of Downs, etc, insurance wouldnt pay for the more accurate test. Wed be ok with paying $600, but then Im worried that any additional diagnostic tests, such as an amnio (if necessary) may also not be covered. What do most moms-to-be do? Do you just take the expanded AFP, or opt for the integrated screening? DH thinks we should just do the expanded AFP, especially as the odds are good that everything is fine, this is probably the test most moms take and that it would be a waste of money. I keep changing my mind. One minute I think its worth it to get the more accurate test, the next I think the AFP test should be fine. Please share your experiences, thoughts. TIA.