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Maine.gov > PFR Home > Insurance Regulation > All Press Releases > Women’s Health Benefits Requirements Unchanged in Maine
Augusta, Maine -
Maine Bureau of Insurance Superintendent Mila Kofman said Monday that recent national advisories will not impact insurance coverage for screening mammograms and Pap tests in Maine.
The U.S. Preventive Services Task Force recently changed its recommendations regarding the age at which women should begin receiving mammograms and the frequency of mammograms thereafter. Its new recommendations suggest mammograms should begin at age 50 for most women, rather than the previous recommendation of age 40. Other medical organizations believe the age 40 recommendation should remain unchanged. Women of all ages continue to be encouraged to discuss this and other health screenings with their physician.
“New advisories and recommendations do not change Maine’s consumer protection standards,” said Superintendent Kofman. “By law, Maine insurance companies are required to cover annual screening mammograms for women 40 years of age and over.”
Within days of the changed mammography recommendations, the American College of Obstetricians and Gynecologists released new guidelines meant to decrease potentially harmful treatment resulting from irregular Pap tests. The new guidelines recommend that women be screened less often and start being screened later in life.
“We want to reassure Maine women that there are important consumer protections in place for cancer screenings related specifically to women’s health,” said Superintendent Kofman. “Maine law is not contingent on advisories from commissions or other groups.”
Maine law requires that HMOs, individual insurance policies and all group insurance policies that cover radiologic procedures must reimburse for screening mammograms performed at least once a year for women 40 years of age and over.
For Pap tests, HMOs and all group health insurance policies have to cover Pap tests. Individual insurance policies, however, are not required to cover Pap tests. Employers with self-insured plans are exempt from state insurance laws by federal law (ERISA) even though the self-insured plan may be administered by an insurance company.
The Bureau of Insurance is part of the Department of Professional and Financial Regulation which encourages sound ethical business practices through high quality, impartial and efficient regulation of insurers, financial institutions, creditors, investment providers, and numerous professions and occupations for the purpose of protecting the citizens of Maine. Consumers can reach the Bureau through its web site at www.maine.gov/insurance; by calling 800-300-5000 in state; or by writing to Bureau of Insurance, 34 State House Station, Augusta ME 04333.
Last Updated: July 26, 2011 7:56 AM
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