The recent PA state legislation, Act 1, marks a significant advancement in women’s healthcare by mandating health plans to cover supplemental diagnostic radiology services and genetic screenings for those at increased risk of breast cancer and BRCA mutations. This legislation is designed to eliminate out-of-pocket costs for these essential health services, ensuring that women who need these screenings can access them without financial barriers.
In response to recent legislative changes, Independence Blue Cross has updated its coverage policies to eliminate cost-sharing for annual supplemental breast cancer screenings and genetic testing for those at increased risk. This change is vital in improving access to preventive care for individuals concerned about breast and ovarian cancer.
Many self-funded health plans already provide BRCA testing under the IBX standard preventive schedule. However, it’s important to note that coverage for supplemental breast cancer screenings, such as breast MRIs or ultrasounds for women at increased risk, is not automatically included. Clients must proactively opt-in to access these essential services.
We are committed to adhering to the latest HRSA recommendations, effective January 1, 2026, which mandate the inclusion of supplemental breast cancer screening in our preventive care services. This update aligns with the Affordable Care Act and will apply to both fully insured and self-funded plans, ensuring that women at average risk have access to essential screenings such as breast MRIs and ultrasounds. Staying compliant with these changes is crucial for businesses and families, as it enhances the overall health and wellness of our community.
We are dedicated to providing exceptional service, so please do not hesitate to contact our dedicated Total Benefit Solutions health insurance specialists at (215)-355-2121 or fill out the contact form below. We are available to answer any questions or address any concerns you may have.