Insurance coverage

At-risk women will get insurance coverage for genetic testing kits under new Crowe Act

MARYVILLE – To streamline the detection process and determine the hereditary risks of breast and ovarian cancers in women, a new law by State Senator Rachelle Crowe requires insurance companies to cover the cost of test kits genetics.

“Early detection through genetic testing is critical for women with a family history of breast or ovarian cancer,” Crowe (D-Glen Carbon) said. “By offering genetic testing at no cost, Illinois can provide comfort and stability to those most at risk.”

According to Centers for Disaster Control and Prevention, the genes most commonly detected in hereditary breast and ovarian cancers are the BRCA1 and BRCA2 genes. About 3% of breast cancers, about 7,500 women per year, and 10% of ovarian cancers, about 2,000 women per year, result from inherited mutations.

Once a test is recommended by a health care provider, Crowe’s Law requires insurance coverage for costs associated with genetic testing for BRCA1 and 2 genes. The measure applies to residents of the Illinois with individual or group insurance policies issued on or after January 1, 2024.

The Illinois Insurance Code requires individual and group health insurance plans to cover annual cancer screenings for women who test positive for BRCA1 or 2 mutations. However, the code did not require health insurance plans to cover genetic mutation testing. Some insurance companies have specific genetic testing criteria or do not cover genetic testing in certain situations, even when considered medically necessary.

“By codifying coverage into law, Illinois is creating a consistent and reliable process for genetic mutation testing for at-risk women,” Crowe said. “Hereditary breast and ovarian cancers pose significant threats to women’s health, and preventive medical treatment can be implemented once the risks are determined.”

House Bill 5334 comes into force on January 1, 2024.