Health Insurance Coverage
Rules concerning health-insurance coverage for genetic tests and services.
Records grouped under the same topic may offer different rights and protections.
This database: 1 record
NHGRI database archive: 129 records
Records about health insurance coverage
Showing 20 of 130; records from this database appear first.
| Jurisdiction | Law or policy | Topics | Status | Summary |
|---|---|---|---|---|
| Mississippi | Jill Gary Eure ActWho Owns Your DNA?Legislation · Effective: July 1, 2026Primary source | Biomarker Testing, Coverage and reimbursement, Health Insurance Coverage, Pharmacogenomics | Enacted | Mississippi enacted the Jill Gary Eure Act, also called Jill's Law, in 2026. The law requires covered health benefit plans, Medicaid, and the State and School Employees Health Insurance Plan to cover qualifying biomarker testing beginning with plans, contracts, or agreements entered into or renewed on or after July 1, 2026. |
| California | 2021 State Bills California 2021 AB 114NHGRI archive2021 legislative sessionPrimary source | Health Insurance Coverage | Enacted | Rapid Whole Genome Sequencing, including individual sequencing, trio sequencing for a parent or parents and their baby, and ultra-rapid sequencing, is a covered benefit for any Medi-Cal beneficiary who is one year of age or younger and is receiving inpatient hospital services in an intensive care unit. Carries over to 2022. |
| California | 2021 State Bills California 2021 AB 1520NHGRI archive2021 legislative sessionPrimary source | Health Insurance Coverage | Died | A health insurance policy that is issued, amended, or renewed on or after January 1, 2022, may not apply a deductible, copayment, or coinsurance to coverage for screening services for prostate cancer for an insured who meets certain criteria. A person is 40 years of age or older and who is high risk, as determined by the attending or treating health care provider meets the criteria. High risk includes, but is not limited to, a person with a prostate who is Black, has a family history of prostate cancer, has a genetic predisposition to prostate cancer, or is a veteran. Carries over to 2022. |
| Connecticut | 2021 State Bills California 2021 HB 5017NHGRI archive2021 legislative sessionPrimary source | Health Insurance Coverage | Died | Requires health_insurance_coverage for genetic cystic fibrosis screenings for women. Died. |
| Connecticut | 2021 State Bills California 2021 SB 6626NHGRI archive2021 legislative sessionPrimary source | Health Insurance Coverage | Died | Requires individual health insurance policies to provide coverage for diagnostic and screening mammograms under certain circumstances. Positive genetic testing for the harmful variant of breast cancer gene one, breast cancer gene two or any other gene variant that materially increases the insured's risk for breast cancer fulfills the criteria for required coverage. Died. |
| Connecticut | 2021 State Bills Connecticut 2021 HB 5687NHGRI archive2021 legislative sessionPrimary source | Health Insurance Coverage | Died | Requires health_insurance_coverage, without any out-of-pocket expense, for: (1) diagnostic and screening mammograms, breast ultrasounds and magnetic resonance imaging of breasts for all insureds; (2) breast biopsies for all insureds, and (3) prophylactic mastectomies and breast reconstruction surgery for all insureds who have the harmful variant of breast cancer gene one (BRCA1), breast cancer gene two (BRCA2) or any similar gene variant that materially increases breast cancer risk. 1/27/2021 Referred to Joint Committee on Insurance and Real Estate. |
| Hawaii | 2021 State Bills Hawaii 2021 HB 249NHGRI archive2021 legislative sessionPrimary source | Health Insurance Coverage | Pending | Requires every group policy of accident and health or sickness insurance and every individual or group hospital or medical service plan contract to provide coverage for screening to determine whether counseling and testing related to the BRCAl or BRCA2 genetic mutation is indicated and genetic counseling and testing related to the BRCAl or BRCA2 genetic mutation, if indicated. Carries over to 2022 session. |
| Hawaii | 2021 State Bills Hawaii 2021 SB 623NHGRI archive2021 legislative sessionPrimary source | Health Insurance Coverage | Pending | Requires every group policy of accident and health or sickness insurance and every individual or group hospital or medical service plan contract to provide coverage for screening to determine whether counseling and testing related to the BRCAl or BRCA2 genetic mutation is indicated and genetic counseling and testing related to the BRCAl or BRCA2 genetic mutation, if indicated. Carries over to 2022 session. |
| Illinois | 2021 State Bills Illinois 2021 HB 1779NHGRI archive2021 legislative sessionPrimary source | Health Insurance Coverage | Enacted | An individual or group health care service plan contract that is issued, amended, delivered, or renewed on or after January 1, 2022 may not require prior authorization for biomarker testing for an insured with advanced or metastatic stage 3 or 4 cancer, nor shall prior authorization be required for biomarker testing of cancer progression or recurrence in the insured with advanced or metastatic stage 3 or 4 cancer. Biomarker testing is defined as analysis of tissue blood or fluid specimen for the presence of a biomarker. Biomarker testing includes, but not limited to, single-analyte tests, multiplex tests, and partial or whole genome sequencing. 7/30/21 Governor approved. Effective 1/1/2022. |
| Illinois | 2021 State Bills Illinois 2021 HB 2109NHGRI archive2021 legislative sessionPrimary source | Health Insurance Coverage | Enacted | Provides that an individual or group policy of accident and health insurance or managed care plan that is amended, delivered, issued, or renewed on or after the effective date of the amendatory Act must provide coverage for medically necessary comprehensive cancer testing and testing of blood or constitutional tissue for cancer predisposition testing as determined by a physician. Comprehensive cancer testing includes, but is not limited to, the following forms of testing: (1) targeted cancer gene panels; (2) whole-exome genome testing; (3) whole genome testing; (4) RNA sequencing; and (5) tumor mutation burden. 8/27/21 Approved by the Governor. Effective 1/1/2022. |
| Louisiana | 2021 State Bills Louisiana 2021 SB 119NHGRI archive2021 legislative sessionPrimary source | Health Insurance Coverage | Enacted | Requires health_insurance_coverage for annual MRI at age 25 and annual mammography at age 30 for women with a hereditary susceptibility to breast cancer based on pathogenic mutation carrier status. 6/1/21 Signed by the Governor. Becomes Act No. 45. Effective 1/1/2022. |
| Louisiana | 2021 State Bills Louisiana 2021 SB 84NHGRI archive2021 legislative sessionPrimary source | Health Insurance Coverage | Enacted | Requires any health coverage plan renewed, delivered or issued for delivery in Louisiana to provide coverage for genetic or molecular testing for cancer including but not limited to tumor mutation testing, next generation sequencing, hereditary germline mutation testing, pharmacogenomic testing, whole exome and genome sequencing, and biomarker testing. 6/1/21 Signed by the Governor. Becomes Act No. 43. Effective 1/1/2022. |
| Massachusetts | 2021 State Bills Massachusetts 2021 H.1113NHGRI archive2021 legislative sessionPrimary source | Health Insurance Coverage | Pending | Requires certain insurers to provide benefits on a nondiscriminatory basis for the diagnosis and treatment of Alfi�s syndrome in individuals. Diagnosis of Alfi's Syndrome includes genetic testing. Carries over to 2022. |
| Massachusetts | 2021 State Bills Massachusetts 2021 H.1175NHGRI archive2021 legislative sessionPrimary source | Health Insurance Coverage | Pending | Requires certain insurers to provide coverage for screening breast ultrasound or screening breast magnetic resonance imaging examination if the patient has additional risk factors for breast cancer including, but not limited to, family history and positive genetic testing. Carries over to 2022. |
| Massachusetts | 2021 State Bills Massachusetts 2021 S.697NHGRI archive2021 legislative sessionPrimary source | Health Insurance Coverage | Pending | Requires certain insurers to provide coverage for screening breast ultrasound or screening breast magnetic resonance imaging examination if the patient has additional risk factors for breast cancer including, but not limited to, family history and positive genetic testing. Carries over to 2022. |
| Minnesota | 2021 State Bills Minnesota 2021 HF 2414NHGRI archive2021 legislative sessionPrimary source | Health Insurance Coverage | Pending | Requires every policy, plan, certificate, or contract referred to in subdivision that provides coverage to a Minnesota resident to provide coverage for all diagnostic and preventive screenings and tests related to breast cancer, including but not limited to genetic testing, breast examination, mammography, magnetic resonance imaging, digital breast tomosynthesis, ultrasound, thermography, biopsy, and other breast cancer screening tests currently being evaluated by the federal Food and Drug Breast Cancer research Foundation. Carries over to 2022 session. |
| Minnesota | 2021 State Bills Minnesota 2021 SF 2320NHGRI archive2021 legislative sessionPrimary source | Health Insurance Coverage | Pending | Requires every policy, plan, certificate, or contract referred to in subdivision that provides coverage to a Minnesota resident to provide coverage for all diagnostic and preventive screenings and tests related to breast cancer, including but not limited to genetic testing, breast examination, mammography, magnetic resonance imaging, digital breast tomosynthesis, ultrasound, thermography, biopsy, and other breast cancer screening tests currently being evaluated by the federal Food and Drug Breast Cancer research Foundation. Carries over to 2022 session. |
| Nevada | 2021 State Bills Nevada 2021 AB 198NHGRI archive2021 legislative sessionPrimary source | Health Insurance Coverage | Died | Requires the State Plan for Medicaid to pay the nonfederal share of expenditures incurred to perform genetic testing to detect birth defects in the fetus of a pregnant woman who is 40 years of age or older. Died. |
| Nevada | 2021 State Bills Nevada 2021 SB 251NHGRI archive2021 legislative sessionPrimary source | Health Insurance Coverage | Enacted | Requires a primary care provider to administer a genetic test for harmful mutations in the BRCA gene if clinically indicated as a result of genetic counseling. The State Plan for Medicaid must pay the nonfederal share of expenditures incurred for screening, genetic counseling and testing for harmful mutations in the BRCA gene for women under circumstances where such screening, genetic counseling or testing is required. Insurers must cover the cost of screening, genetic counseling and testing for harmful mutations in the BRCA gene for women under circumstances where such screening, genetic counseling or testing is required. 5/27/2021 Approved by the Governor. Effective 1/1/2022. |
| New York | 2021 State Bills New York 2021 A1758NHGRI archive2021 legislative sessionPrimary source | Health Insurance Coverage | Pending | Requires accident and health insurance policies to cover the cost of genetic testing of persons with a family history of cancer when the attending physician determines such person has a significant risk thereof. Carries over to 2022. |