As of Jan. 1, insurers in Illinois are required in many cases to fully cover the cost of second, or diagnostic mammograms. Routine screening mammograms are free under the Affordable Care Act, but many patients have delayed getting mammograms out of fear they would be called back for costly follow-up testing. In Illinois, patients with private insurance may pay more than $600 out of pocket for diagnostic mammograms and may need to pay even if insurance has covered it. The new law does not apply to patients who are members of self-funded insurance plans, which are regulated by the federal government and not the state, and it is unclear if the law will apply to people with high-deductible health plans because of a conflict with federal tax law. Experts are hopeful the new law will encourage more people to get mammograms, especially given that Illinois Health Department data reveals about 1,775 people died of breast cancer in Illinois in 2018. Another Illinois law requires insurance coverage of screening with an ultrasound or MRI for women who have dense breast tissue, which can make cancer harder to detect with mammograms.
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Tags: insurance , Illinois , Affordable Care Act