Pennsylvania Law Requiring Insurers to Cover Breast MRIs, Ultrasounds Now in Full Effect

I am new to this group and found my way here from the r/Reduction group. I thought this may be a good place to share this information I just found out from my Dr.

I am in the process of jumping through the hoops to get a breast reduction. One of the requirements is to provide mammogram results. So I went and got one, they observed 2 “probably benign cysts” and said to come back in 6 months. AND to wait to do the reduction procedure until I get then. Or I could request a “fast MRI”, get the results and then get my surgery. BUT the DR told me insurance doesn’t cover that.

So I called my obgyn to get the MRI script bc I am getting it either way. She informed me of a new law passed in Pennsylvania that requires insurance to cover breast MRIs for the following reasons:

A personal history of breast cancer

A family history of breast cancer

A genetic predisposition to breast cancer

Extremely dense breast tissue

Heterogeneously dense breast tissue with 1 additional high-risk factor

Luckily, I guess, I meet one of those qualifications.

I was not aware of this law, and I am not sure what other states may have it as well, but I wanted to share it here in case it may help others – and save them $ from paying out of pocket.

Here is the website:https://www.porh.psu.edu/pennsylvania-law-requiring-insurers-to-cover-breast-mris-ultrasounds-now-in-full-effect/#:~:text=Beginning%20January%201%2C%202022%2C%20all,Bob%20Mensch.