SPRINGFIELD – A measure sponsored by State Senator Linda Holmes (D-Aurora) expanding insurance coverage for diagnostic mammograms has been signed into law by the governor.
Currently, insurance covers an initial screening mammogram without any co-pay or cost sharing. If dense breast tissue or an abnormality is detected, a doctor will want a second look with a more comprehensive ultrasound (diagnostic) mammogram, and a co-pay is applied. In Illinois, those co-pays can run from $600 to $700, which could discourage women from getting that screening.
“A diagnostic mammogram should be covered in the same manner as a routine screening mammogram,” Holmes said. “About 10 percent of initial mammogram results require a subsequent diagnostic mammogram, which can arguably be the most important test in the screening process. This new law can save lives.”
According to a study by the Illinois Department of Public Health, 26 women are diagnosed with breast cancer in Illinois each day.
“More thorough testing can mean earlier detection and better odds at treating breast cancer, which is critical,” Holmes said. “I see no reason for insurers to discriminate against these women or delay their treatment by burdening them with the prospect of out-of-pocket costs.”
The legislation was an initiative of Susan G. Komen and the Illinois Public Health Association.
Senate Bill 162 will take effect January 1, 2020.