Questions for your Insurer
Act 1 of 2023 eliminates all costs associated with screening breast MRI, ultrasound, genetic testing and counseling for individuals at increased risk, insured under Pennsylvania law. Ask your insurer if that includes your plan.
Questions
I’m at high risk for breast cancer and my doctor typically recommends breast MRI or ultrasound. Will these screenings be covered at no cost under Act 1 when it goes into effect?
Am I insured under Pennsylvania law or am I insured under federal law?
- opens in a new windowAct 1 of 2023 applies to individuals insured under Pennsylvania law only. Ask your insurer or your benefits administrator if that includes your plan. Federal law covers many types of insurance including Medicare, Medicaid and ERISA plans, among others. Federally regulated plans are not covered by Act 1.
When will my no-cost coverage of breast MRI, ultrasound, genetic testing and counseling begin?
- All state-regulated insurance plans should have implemented Act 1 as of January 1, 2025. If you are at an increased risk for breast cancer and your state-regulated insurance plan is not covering your MRI, ultrasound, genetic testing or counseling, please contact the Pennsylvania Insurance Department at 877-881-6388. opens in a new windowClick here for our Act 1 insurance coverage guide.opens PDF file
