MINNEAPOLIS— This session, the Minnesota Legislature passed new health insurance coverage requirements in an effort to reduce out-of-pocket health care costs.
Abortions, gender-affirming care, prosthetics and wigs for cancer patients are among the new mandates for health plans. The approved changes will take effect on January 1.
Here’s what you need to know:
Wigs
Minnesota law had previously required insurers to cover wigs for people with alopecia, but former DFL Senate Majority Leader Kari Dziedzic, who is battling cancer, introduced legislation to expand it to anyone who has hair loss due to alopecia. health condition. This also applies to patients like those dealing with cancer.
Wigs can cost anywhere a few hundred dollars to $5,000, leaving some priced out of buying one despite its benefits. Proponents say it helps people find a sense of self-worth when their bodies undergo treatment that changes the way they look.
“When it comes to something that people think is as trivial as wigs, it’s not. It’s very important. It’s very empowering. It gives you a sense of normalcy,” Haley Erickson, a breast cancer survivor, told me. , to WCCO.
Coverage is limited to $1,000 per benefit year and is subject to copayments and deductibles required for similar items under the policy.
“If we put 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-screening and follow-up services must be covered by “no payment, coinsurance, deductible, or other cost sharing for enrollees that exceeds the cost sharing applicable to similar services,” the law says.
It also limits any limitations on coverage, such as prior authorization, referral requirements, limitations or delays.
Religious organizations are exempt from this coverage if they have objections, but the law requires them to notify employees during the application process and anyone else already working there at least 30 days before enrolling in a health plan.
Gender-affirming care
Lawmakers also codified insurance coverage for gender-affirming care for transgender people if a doctor determines that treatment is medically necessary. There are also exceptions for religious organizations, similar to the new abortion provisions.
The law defines gender-affirming care as “any 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.” .”
Orthoses and prosthetics
Insurers must provide coverage for orthotic and prosthetic devices, supplies and services “at least equal to the coverage provided under federal law,” the statute says. Prior approval 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 work out this year: Infertility treatment
A group of families struggling with infertility met in the state capitol several times this session to pressure lawmakers to mandate insurance coverage for treatments such as in vitro fertilization.
In the end it didn’t make it to the finish. DFL House Speaker Melissa Hortman told reporters in March that a statewide mandate would be expensive and that they did not have the capacity to pass it this session — it was not a budget year in which lawmakers would reduce spending for the government and its programs for determined over the next two years. .
They will start doing that again next session.
Miraya Gran of Bloomington hopes lawmakers will then take another look at the proposal. She told WCCO that her family’s future depends on it. Her insurance doesn’t cover IVF and she and her husband have already spent tens of thousands of dollars and taken out a second mortgage to have their three-year-old daughter Isla.
“The financial, emotional and physical burden took its 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 deserves treatment, which should then be covered by insurance,” Gran said.
