LAW TO IMPROVE INSURANCE COVERAGE FOR CANCER TREATMENT TAKES EFFECT

Senator Cain-sponsored bill requires equal coverage for oral and IV cancer treatment

AUGUSTA— A new law to improve insurance coverage for cancer treatment will take effect on Friday, August 1.

“When patients are talking with their doctors about their treatment plans, they should be able to choose the option that works best for them, without forcing them and their families to pay thousands of dollars in out-of-pocket expenses,” said Senator Emily Cain of Orono, the sponsor of the bill. “Whether anti-cancer medication is in pill form or via an IV, it is still anti-cancer medication and should be treated the same by insurance companies. This law will ensure patients are not unfairly burdened simply because their treatment comes in a different form.”

The new law will level the playing field for insurance coverage by requiring that health insurance companies cover anti-cancer medication taken in pill form in the same way they cover other chemotherapy treatments.

Prior to Senator Cain’s bill, insurance companies viewed intravenous cancer treatments as medical treatments with standard copays while oral anti-cancer medications were treated as prescriptions and patients were required to pay higher copayments as well as a percentage of the drug’s cost.

Even for well insured patients, out-of-pocket costs for oral anti-cancer drugs are extremely high, ranging from hundreds to thousands of dollars per month, compared to intravenous treatments that usually require just an office co-pay of no more than $30.

“This law will eliminate a barrier to essential access for hundreds of Maine patients and their families who are now paying thousands of dollars out of pocket for life-saving medicine that should be covered by insurance,” added Senator Cain.

The text of the new law is available here.

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