SB00088 AN ACT REQUIRING INSURANCE COVERAGE FOR SCALP COOLING. |…

Plain English Breakdown

The official text specifies coverage types by referencing subdivisions of section 38a-469, but does not list those specific subdivision names in the provided excerpt.

Act Requiring Insurance Coverage for Scalp Cooling

This law requires individual and group health insurance policies that cover chemotherapy to also provide coverage for scalp cooling systems starting January 1, 2027.

What This Bill Does

Requires individual and group health insurance policies covering chemotherapy to include coverage for scalp cooling systems used with such treatment.
Sets the level of coverage for these devices at least equal to what Medicare provides.
Limits out-of-pocket costs like copayments or deductibles so they are not higher than those applied to other benefits in the policy, except for high deductible health plans regarding deductibles.
Allows insurers to require prior authorization if that rule is used for other covered medical services under the same policy.

Who It Names or Affects

Individuals with individual or group health insurance policies delivered, issued, renewed, amended, or continued in the state on or after January 1, 2027.
Health insurance companies issuing these specific types of policies that cover chemotherapy.

Terms To Know

Scalp cooling system: A device designed for repeated medical use to cool the human scalp to prevent or reduce hair loss caused by chemotherapy.
Prior authorization: Approval required from an insurance company before receiving a service, allowed here only if used in the same way as other covered benefits under the policy.

Limits and Unknowns

The law applies only to policies delivered, issued for delivery, renewed, amended, or continued on or after January 1, 2027.
High deductible health plans are exempt from specific limits regarding deductibles and Medicare coverage levels set by this act.
Coverage is required only if the policy already provides coverage for chemotherapy.

Official Summary Text

To implement the Governor's budget recommendations.

Current Bill Text

Read the full stored bill text

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General Assembly Governor's Bill No. 88
February Session, 2026 LCO No. 527

Referred to Committee on INSURANCE AND REAL ESTATE

Introduced by:
Request of the Governor Pursuant
to Joint Rule 9

AN ACT REQUIRING INSURANCE COVERAGE FOR SCALP
COOLING.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:

Section 1. (NEW) (Effective January 1, 2027) (a) For the purposes of this 1
section, "scalp cooling system" means any device designed and intended 2
for repeated medical use to cool the human scalp to prevent or reduce 3
hair loss as a result of chemotherapy. 4
(b) (1) Each individual health insurance policy providing coverage of 5
the type specified in subdivisions (1), (2), (4), (11), (12) and (13) of section 6
38a-469 of the general statutes delivered, issued for delivery, renewed, 7
amended or continued in this state on or after January 1, 2027, that 8
provides coverage for chemotherapy shall provide coverage fo r scalp 9
cooling systems used in connection with such chemotherapy that is at 10
least equivalent to such coverage provided under Medicare. 11
(2) No policy described in sub division (1) of this subsection shall 12
impose a coinsurance, copayment, deductible or other out -of-pocket 13
expense for any such scalp cooling system that is more restrictive than 14

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that imposed on substantially all other benefits provided under such 15
policy, except that a high deductible health plan, as such term is used in 16
subsection (f) of section 38a -493 of the general statutes, shall not be 17
subject to the deductible limits set forth in this subdivision or under 18
Medicare pursuant to subdivision (1) of this subsection. 19
(c) Any individual health insurance policy may require prior 20
authorization for scalp cooling system s, provided such prior 21
authorization is required in the same manner and to the same extent as 22
is required for other covered benefits under such policy. 23
Sec. 2. (NEW) ( Effective January 1, 2027 ) (a) For the purposes of this 24
section, "scalp cooling system" means any device designed and intended 25
for repeated medical use to cool the human scalp to prevent or reduce 26
hair loss as a result of chemotherapy. 27
(b) (1) Each group health insurance policy providing coverage of the 28
type specified in subdivisions (1), (2), (4), (11) , (12) and (13) of section 29
38a-469 of the general statutes delivered, issued for delivery, renewed, 30
amended or continued in this state on or after January 1, 2027, that 31
provides coverage for chemotherapy shall provide coverage for scalp 32
cooling systems used in connection with such chemotherapy that is at 33
least equivalent to such coverage provided under Medicare. 34
(2) No policy described in subdivision (1) of this subsection shall 35
impose a coinsurance, copayment, deductible or other out -of-pocket 36
expense for any such scalp cooling system that is more restrictive than 37
that imposed on substantially all other benefits provided under such 38
policy, except that a high deductible health plan, as such term is used in 39
subsection (f) of section 38a -520 of the general statutes, shall not be 40
subject to the deductible limits set forth in this subdivision or under 41
Medicare pursuant to subdivision (1) of this subsection. 42
(c) An y group health insurance policy may require prior 43
authorization for scalp cooling systems, provided such prior 44
authorization is required in the same manner and to the same extent as 45

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is required for other covered benefits under such policy. 46
This act shall take effect as follows and shall amend the following
sections:

Section 1 January 1, 2027 New section
Sec. 2 January 1, 2027 New section

Statement of Purpose:
To implement the Governor's budget recommendations.

[Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline, except
that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not
underlined.]