Illinois Enacts Comprehensive Cancer Screening Coverage Law
Illinois Governor signed into law the Public Act 103-0030, a significant legislative measure aimed at expanding health insurance coverage for critical cancer screenings. The law, which will take effect on January 1, 2025, mandates that group health insurance policies include coverage for cervical, prostate, and ovarian cancer screenings without any cost-sharing requirements such as deductibles or copayments.
Under the new legislation, annual cervical smear or Pap smear tests will be covered for all female insureds. This move is aimed at enhancing early detection of cervical cancer, which is vital for successful treatment outcomes. Additionally, the law introduces mandatory coverage for annual prostate cancer screenings for male insureds following a physician’s recommendation. The screenings are particularly focused on:
- Asymptomatic men aged 50 and over,
- African-American men aged 40 and over,
- Men aged 40 and over with a family history or genetic predisposition to prostate cancer.
The law also addresses the need for surveillance tests for ovarian cancer for female insureds considered at risk due to family history or genetic factors, such as the presence of BRCA1 or BRCA2 mutations.
The inclusion of these provisions in health insurance policies aims to remove financial barriers that may prevent individuals from undergoing these potentially life-saving screenings.
However, the law specifies exceptions where the coverage for prostate cancer screenings would disqualify a high-deductible health plan from being eligible for a health savings account under federal tax law. It also does not apply to policies that only provide coverage for specified diseases or limited benefit coverage.
