Abortion, wigs for cancer patients, IVF: Health insurance coverage changes in Minnesota
MINNEAPOLIS — This session, the Minnesota Legislature approved new coverage requirements for health insurance plans in an effort to reduce out-of-pocket care costs.
Abortions, gender-affirming care, prosthetics and wigs for cancer patients are among the new mandates for health plans. The changes approved will go into effect January 1.
Here's what you need to know:
Wigs
Minnesota law had previously required insurers cover wigs for people with alopecia, but former DFL Senate Majority Leader Kari Dziedzic, who is battling cancer, introduced legislation to extend it to anyone who has hair loss due to a health condition. That includes patients like her dealing with cancer.
Wigs can cost anywhere from a couple hundred dollars to $5,000, leaving some priced out of getting one despite its benefits. Advocates say it helps people find a sense of self when their body is going through treatment that changes the way they look.
"When it comes to something people may think is as trivial as wigs -- it's not that. It's very important. It's very empowering. It gives you some sense of normalcy," Haley Erickson, a breast cancer survivor, told WCCO.
The coverage is limited to $1,000 per benefit year and it is subject to co-pays and deductibles required for similar items under the policy.
"If we are putting patients first, we will pass this bill to help patients move forward," Dziedzic said during a committee hearing in March.
Abortion
Abortions and any pre-screenings and follow-up services must be covered with "no-payment, coinsurance, deductible, or other enrollee cost-sharing that is greater than the cost-sharing that applies to similar services," according to the statute.
It also restricts any limitations on coverage, like prior authorization, referral requirements, restrictions, or delays.
Religious organizations are exempt from providing this coverage if they have objections, but the law requires that they notify employees during the job hiring process and everyone else already working there at least 30 days before they enroll in health plans.
Gender-affirming care
Lawmakers also codified insurance coverage for gender-affirming care for transgender people if a doctor determines treatment to be medically necessary. There are also exemptions for religious organizations, similar to the new abortion provisions.
The law defines gender-affirming care as "all medical, surgical, counseling, or referral services, including telehealth services, that an individual may receive to support and affirm the individual's gender identity or gender expression and that are legal under the laws of this state."
Orthotics and prosthetics
Insurers must offer coverage for orthotic and prosthetic devices, supplies and services, "at least equal to the coverage provided under federal law," the statute says. Prior authorization may be required.
More than 28,000 Minnesotans live with limb loss, according to the group So Everybody Can Move. Out-of-pocket costs without health plan coverage can cost families $5,000 to $50,000.
What didn't pass this year: Infertility treatment
A group of families struggling with infertility rallied at the state capitol a few times this session to push lawmakers to mandate insurance coverage for treatments like in-vitro fertilization.
Ultimately it did not clear the finish line. DFL House Speaker Melissa Hortman told reporters in March a statewide mandate would be expensive and they did not have the capacity to pass it this session–it was not a budget-writing year when lawmakers set spending for the government and its programs for the next biennium.
They will begin that work again next session.
Miraya Gran of Bloomington hopes then the legislature will give the proposal a second look. She told WCCO the future of her family depends on it. Her insurance does not cover IVF and she and her husband have already spent tens of thousands of dollars and took out a second mortgage in order to have their three-year-old daughter Isla.
"The financial, emotional and physical burden took a toll on me and my husband," she said.
Twenty-one other states and Washington, D.C., have passed laws requiring coverage, according to a national infertility organization.
"I just want to make it better for other people because infertility is a disease and it deserves treatment, which then deserves insurance coverage," Gran said.