It’s a big part of Anastasia Kathrens-Gallardo’s job as a genetic counselor at Loyola Medicine.
“Making sure everybody is aware that this testing is available for people who have a strong family history of breast, ovarian, even pancreatic and prostate cancer, can be linked to the BRCA1 and BRCA2 genes,” Kathrens-Gallardo said.
As of Jan. 1, 2023, HB 05334 requires health insurance plans to cover costs for genetic testing for BRCA1 and BRCA2 genes to detect risks for breast and ovarian cancer, if recommended by a physician.
“The cost of genetic testing has gone down dramatically in the last few years, but insurance coverage and cost of testing, it can still be a barrier for patients,” Kathrens-Gallardo said.
A second law, HB 05318, requires health insurance to cover annual prostate cancer screenings upon the recommendation of a doctor.
“We always welcome a change in law that will make access to care easier, but you know, particularly in these cases, it is especially timely,” said Dr. Alex Gorbonos, a urologic oncologist with Loyola Medicine.
Dr. Gorbonos says many men delayed screenings during the pandemic, but knowing they are covered may serve as motivation to get screened now.
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“I think it's important to screen it, especially in populations that are susceptible to it, a man with a positive family history and African American men,” Dr. Gorbonos said.
“We know at the American Cancer Society through extensive research that people who don't have adequate coverage for these vital screenings are not going to be able to access them,” said Ally Lopshire, the government relations director for the Illinois chapter of the American Cancer Society.
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That’s why the American Cancer Society supports these new laws.
“When we say coverage, we're also trying to make sure that the cost share, what the patient actually pays when they go to get the service, is low or even negligible,” Lopshire said.
It’s important to note that these new state laws only apply to state-regulated insurance plans.
“Any plan that is regulated by state law, which would be your Medicaid plans, plans on the exchanges, certain employer plans, those are what's going to be impacted,” Lopshire said.
If you’re not sure if a test or screening is covered, you should ask questions first.
“It can be very confusing, so we encourage people to call their insurance company and ask them what type of plan they have or you can call the Illinois Department of Insurance. They can help you navigate those things,” Lopshire said.
