Highmark Health plan members to receive full coverage for diagnostic breast cancer studies, MRIs
The plan went into effect on January 1st, 2026, marking a significant step forward in healthcare accessibility. This initiative aims to eliminate financial barriers for women seeking routine breast cancer screenings and follow-ups.
Dr. Matthew Miller, director of breast imaging at AHN, emphasized the importance of this coverage, stating, 'Screen was always covered, but the next step in the process, diagnostic workup, is now 100% covered, which is huge.'
In the past, financial concerns often prevented women from returning for follow-up screenings, resulting in delayed diagnoses of advanced breast cancer. Dr. Miller shared a relatable scenario: 'And then they come back a year later, and they have advanced disease, and we ask, 'You know, we saw something last year. Why didn't you come back?' And they say, 'Well, I didn't want to be on that hook for, you know, sometimes $300 of a copay.''
The recent signing of Senate Bill 88 by Governor Josh Shapiro mandates all health insurance coverage for these diagnostic imaging services, with most insurance companies expected to implement the plan later in the year. However, Highmark Health took a proactive approach, implementing the coverage immediately.
Dr. Miller praised Highmark's decision, stating, 'Highmark kind of hopped the gun on it and said, 'Listen, it's time. We're in, rip the band-aid off, and we're covering it Jan. 1.''
This initiative aligns with Highmark Health's and the Allegheny Health Network's commitment to early detection. Miller added, 'Anyone above the age of 40 who hasn't had a mammogram within a year can come in and get a mammogram. Patients can visit AHN's walk-in mammography clinics every day until noon at eight centers.'
Recognizing the challenges of scheduling, Miller noted, 'People have busy schedules, and sometimes, it's hard to put something on your calendar. If you have half an hour, you can walk in.'
Highmark Health's proactive approach to covering diagnostic breast cancer studies and MRIs is a significant step towards ensuring that financial barriers do not prevent women from accessing essential healthcare services.
