A new law signed by Connecticut Governor Lamont will significantly expand the range of treatments that health insurers in the state are required to cover, a change that supporters say could save some patients thousands of dollars. The measure broadens mandated coverage in several areas that until now have often left families paying large sums out of their own pockets, even when they already held insurance.
One of the central provisions concerns prosthetic limbs. Under the previous rules, insurers would frequently pay for a basic prosthetic designed only for walking, but not for versions built for more active use. Advocates argued that this left many people, including children, unable to take part in sports and everyday physical activities. As one Connecticut mother whose daughter lost a leg at the age of 10 put it, children need to be able to do far more than simply walk, and instead to run, swim, jump and play.
For families in that situation, even the most advanced prosthetic technology made little practical difference if insurance would not pay for it. The new law is intended to close that gap by requiring coverage of prosthetics designed for running, swimming and other physical activity, so that recipients, and especially young people, are no longer limited to a single device meant only for basic mobility around the home.
The law also requires insurers to cover scalp cooling for patients undergoing chemotherapy, a treatment that can help people keep much of their hair during cancer care. Paid for out of pocket, scalp cooling can cost up to 3,000 dollars. Patients have described how being able to retain their hair offered them a rare sense of control at a moment when so much else in their lives felt as though it was slipping beyond their grasp.
A third major change extends coverage to non-medical fertility treatment. At present, many single mothers and same-sex couples in Connecticut have had to pay for such treatment themselves, even when they carry insurance. Supporters of the law argued that the desire to become a parent should not be defined or limited by a person's marital status, their sexual orientation, or the particular path they choose to take toward starting a family.
The changes did not come easily. Supporters described a five-year effort to get the measures through the state legislature, where they faced sustained resistance. Insurers warned that the new mandates would push up the cost of coverage, estimating premium increases of between 7 and 9 percent. For a family of four, they said, that could translate into paying somewhere between 2,800 and 3,600 dollars more each year for their health plan.
The new requirements are due to take effect on January 1. Even then, they will not reach everyone in the state, applying only to the roughly half of the population covered by state-regulated health insurance. For those who do benefit, however, supporters say the savings, particularly for families dealing with disability, cancer treatment or fertility care, could be substantial and, in some cases, genuinely life changing.