BALTIMORE, Md. — On New Year’s Eve in 2019 Rhonda Hayes went in for a biopsy, a few days later she was diagnosed with breast cancer.
“Every morning you’re walking up doing this, touching your hair. On my birthday, I was touching my head, my hair was in my hand. That was devastating,” said Hayes, a breast cancer survivor.
Bills for follow up exams quickly started to pile on.
“$50…$100… I had to get a lymphedema machine for $2,000,” said Hayes.
While Hayes is now cancer-free, she hopes that the new laws for health insurance coverage will help others.
One of the changes prevents private insurers from collecting co-payments for breast examinations. Mammography screenings are already covered under Maryland law, but it now extends to certain biopsies and follow-up exams.
“An MRI that can potentially can cost anywhere from $250 to $500, the costs start adding up,” said Adam Richter, a Partner with Main Line Benefits.
Insurance plans will also be required to cover biomarker testing, which helps doctors determine the best course of treatment for patients with Parkinson’s Disease or cancer. The Trans Health Equity Act also takes effect, expanding coverage for gender-affirming care as an essential health benefit.
“That’s a pretty big breakthrough for that community. A lot of these pieces of coverage were already built into the traditional health plans that people would get through a company like BlueCross, United HealthCare, Aetna or Kaiser, the companies that are available in Maryland. Now its referring to coverages in Medicaid,” said Richter.
The coverage can offset costs for medical and mental health services that includes voice modification procedures and other surgeries.
“We’re talking tens of thousands of dollars for the more invasive and major type of surgeries and treatments,” said Richter.
