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The chart below identifies states with laws that require insurance coverage for MRI and ultrasound screenings for breast cancer for individuals at high risk.
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| State | Has a Law Requiring MRI or Ultrasound Screening for Individuals at High Riks for Breast Cancer | Date Passed | Summary of Law Requiring MRI or Ultrasound Screening for Individuals at High Risk for Breast Cancer | Has Pending Legislation Requiring Screening for Individuals at High Risk for Breast Cancer | Summary of Pending Legislation Requiring MRI or Ultrasound Screening for Individuals at High Risk for Breast Cancer | Status of Pending Legislation | ||
|---|---|---|---|---|---|---|---|---|
| ALABAMA | ||||||||
| ALASKA | HB 285 (2023-2024) - Mammograms: Insurance Coverage | https://www.akleg.gov/basis/Bill/Detail/33?Root=HB285 | Would expand the definition of "supplemental breast examination" to include breast MRI and ultrasound for individuals at higher risk of breast cancer and prohibits cost-sharing (such as deductibles, copayments, or coinsurance) for these supplemental exams as well as diagnostic and screening mammograms under health insurance plans. Proposed effective date: January 1, 2025. | Died in committee - Inactive | ||||
| ARIZONA | HB 2684 (2023) - Insurance; breast screenings; cost sharing.. | https://apps.azleg.gov/BillStatus/BillOverview/79547 | Would prohibit cost sharing (including deductibles, copayments, coinsurance, out-of-pocket maximums, or similar expenses) for breast health examinations (screenings, diagnostic exams, and supplemental exams) that include breast MRI and ultrasound for individuals at higher risk of breast cancer under various health insurance plans. Proposed effective date: January 1, 2025. | Died in committee - Inactive | ||||
| ARKANSAS | Act 553 (2025) - To Amend The Law Concerning Coverage For Mammograms And Breast Ultrasounds. | 4/14/2025 | https://arkleg.state.ar.us/Home/FTPDocument?path=%2FACTS%2F2025R%2FPublic%2FACT553.pdf | Amends the definition of “supplemental breast examination” to include contrast-enhanced mammography, breast magnetic resonance imaging (MRI), breast ultrasound, and molecular breast imaging (when clinically appropriate and indicated by risk factors or dense breast tissue per NCCN Guidelines) and mandates that no additional cost-sharing be imposed for diagnostic or supplemental breast examinations under health insurance plans. Approved effective date: April 14, 2025. | ||||
| CALIFORNIA | ||||||||
| COLORADO | HB 1301 (2019) - Health Insurance For Breast Imaging | 5/16/2019 | https://leg.colorado.gov/bills/hb19-1301 | Requires health insurance plans to cover an annual breast cancer screening using a noninvasive imaging modality (such as MRI or ultrasound) deemed appropriate by the provider and approved by guidelines from bodies like ACR or NCCN, for individuals at elevated risk (e.g., due to family history, age 40+, or risk model assessment); if provider-recommended and guideline-concordant, no cost-sharing applies. Effective for policies issued or renewed on or after January 1, 2021. | ||||
| CONNECTICUT | CT Public Act No. 22-90 - An Act Concerning Required Health Insurance Coverage For Breast And Ovarian Cancer Susceptibility Screening. | 5/31/2022 | https://www.cga.ct.gov/asp/cgabillstatus/cgabillstatus.asp?selBillType=Bill&bill_num=SB00358&which_year=2022 | Requires health insurance policies to cover diagnostic and screening breast ultrasounds and breast MRIs for individuals at increased risk of breast cancer (including those with dense breast tissue, family or personal history of breast cancer, positive high-risk genetic test results, prior chest radiation, or other provider-identified risk factors) with no cost-sharing such as coinsurance, copayments, or deductibles. Effective date: January 1, 2023. | ||||
| DELAWARE | HB 60 (2023-2024) - An Act To Amend Titles 18, 29, And 31 Relating To Breast Cancer Screening And Diagnostic Procedures. | 7/26/2023 | https://legis.delaware.gov/BillDetail?LegislationId=140402 | Requires all applicable health insurance plans (including group, blanket, and individual policies, state employee plans, and Medicaid) to cover diagnostic and supplemental breast examinations (such as breast MRI and ultrasound in addition to mammograms) on the same terms as annual screening mammograms, meaning cost-sharing (like deductibles, copayments, or coinsurance) must be no less favorable than what applies to screening mammography. Effective for policies issued, renewed, modified, altered, amended, or reissued after December 31, 2024. | ||||
| *DISTRICT OF COLUMBIA | D.C. Law § 31-2902 - Payable benefits. | 3/22/2019 | https://code.dccouncil.gov/us/dc/council/code/sections/31-2902 | Requires all individual and group health plans (including Medicaid) to cover adjuvant breast cancer screening using breast MRI, ultrasound, or molecular breast imaging (in addition to baseline and annual 3-D mammograms) without cost-sharing (no annual deductible, coinsurance, or copayment), for individuals with dense breast tissue (Class C or D) or those deemed at increased risk due to factors like family or personal breast cancer history, positive genetic testing, or other clinician-determined risks. | ||||
| FLORIDA | HB 773 (2024) / SB 932 (2024) - Coverage for Diagnostic and Supplemental Breast Examinations | https://www.flsenate.gov/Session/Bill/2024/773 | Would define “diagnostic breast examination” to include medically necessary imaging such as diagnostic mammography, breast MRI, or breast ultrasound to evaluate an abnormality, and would define “supplemental breast examination” as breast MRI or ultrasound used for screening in individuals with elevated risk based on personal or family history or other factors; would prohibit cost-sharing (including deductibles, copayments, or coinsurance) for these diagnostic and supplemental breast examinations under the state group insurance program. Proposed effective date: January 1, 2025. | Died in committee - Inactive | ||||
| GEORGIA | HB 315 (2023-2024) - Commission of Insurance; promulgate rules and regulations regarding cost-sharing requirements for diagnostic and supplemental breast screening examinations | 5/2/2023 | https://www.legis.ga.gov/legislation/64161 | Requires health benefit policies (including individual and group plans) to cover diagnostic and supplemental breast screening examinations (such as breast MRI and ultrasound) without cost-sharing (deductibles, coinsurance, or copayments) when medically necessary and clinically appropriate, as defined by the NCCN guidelines as of January 1, 2022. Mandates that the cost-sharing requirements for these examinations be no less favorable than those applicable to screening mammography. Effective date: May 2, 2023. | ||||
| HAWAII | SB 189 (2025) - Relating To Breast Cancer Screening. | https://www.capitol.hawaii.gov/session/measure_indiv.aspx?billtype=SB&billnumber=189&year=2025 | Would expand mandatory health insurance coverage for low-dose mammography to include any supplemental imaging deemed medically necessary (such as breast MRI, ultrasound, or digital breast tomosynthesis) for patients of any age with an above-average risk of developing breast cancer, as determined by a risk-factor modeling tool or the patient’s primary care provider. Proposed ffective date: January 1, 2026. | Died in committee - Inactive | ||||
| IDAHO | HB 134 (2025) - Adds to existing law to establish provisions regarding breast cancer screening. | 3/25/2025 | https://legislature.idaho.gov/sessioninfo/2025/legislation/H0134/ | Mandates health insurance plans to cover 1 annual supplemental breast screening at no cost for individuals at increased risk of breast cancer, including those with personal or family history, genetic predisposition, prior radiation therapy, or dense breast tissue. Supplemental screenings encompass breast MRI, contrast mammography, or ultrasound, as recommended by a physician. Effective date: January 1, 2026. | ||||
| ILLINOIS | 55 ILCS 5/5-1069162 - Insurance-Diagnostic Mammogram | 8/26/2019 | https://www.ilga.gov/Documents/legislation/ilcs/documents/005500050K5-1069.htm | Requires coverage for diagnostic mammograms when medically necessary, as determined by a health care provider. Expands coverage for comprehensive ultrasound screenings and MRIs. Prohibits certain cost-sharing requirements for the newly required coverage, with some exceptions. Effective date: January 1, 2020. | ||||
| INDIANA | HB 1114 (2024) - Coverage for cancer screening and prescriptions. | https://iga.in.gov/legislative/2024/bills/house/1114/details | Proposes that state employee health plans, accident and sickness insurance policies, and health maintenance organizations cover supplemental breast examinations (such as breast MRI and ultrasound) without imposing cost-sharing requirements. Would prohibit insurers from requiring patients to fail a prior prescription drug before covering a new treatment for advanced, metastatic cancer. Proposed effective date: July 1, 2024. | Died in Committee - Inactive | ||||
| IOWA | HB 2489 (2023-2024) - A bill for an act relating to insurance coverage for supplemental and diagnostic breast examinations. | 5/1/2024 | https://www.legis.iowa.gov/legislation/BillBook?ga=90&ba=HF2489 | Mandates that health insurance plans in Iowa, including individual and group policies, HMOs, and public employee plans, provide coverage for supplemental and diagnostic breast examinations (such as breast MRI and ultrasound) when deemed medically necessary. The coverage must be no less favorable than that for screening mammograms. Effective date: January 1, 2025. | ||||
| KANSAS | HB 2296 / SB 219 (2025) - Requiring that certain health insurance plans impose a no-cost sharing requirement for a diagnostic or supplemental breast cancer examination for breast cancer imposed on an insured. | https://kslegislature.gov/li/b2025_26/measures/hb2296/ | Health insurance policies in Kansas would be required to cover diagnostic and supplemental breast cancer examinations (including breast MRI and ultrasound) without imposing any cost-sharing requirements (such as deductibles, copayments, or coinsurance) on insured individuals. Proposed effective date: January 1, 2026. | Died in committee - Inactive | ||||
| KENTUCKY | HB 115 (2024) - An Act relating to coverage for breast examinations | 4/5/2024 | https://apps.legislature.ky.gov/record/24RS/hb115.html | Expands insurance coverage to include breast magnetic resonance imaging (MRI) and ultrasound as medically necessary supplemental breast examinations for individuals at high risk of breast cancer, based on personal or family medical history or other risk factors. Prohibits cost-sharing for these diagnostic and supplemental imaging services and requires compliance from state-regulated health plans. Effective date: January 1, 2025. | ||||
| LOUISIANA | SB 338 (2024) - Requires health coverage plans to include alternative imaging methods to mammography | 5/3/2024 | https://www.legis.la.gov/legis/BillInfo.aspx?s=24rs&b=SB338&sbi=y | Mandates that health insurance plans cover supplemental breast cancer screening methods (such as breast MRI, contrast-enhanced mammography, and breast ultrasound) for individuals at high risk of breast cancer. This includes patients with a personal or family history of breast cancer or other risk factors.Requires these services to be provided without cost-sharing, including deductibles, copayments, or coinsurance. Applies to new policies issued on or after January 1, 2025, and to existing policies upon renewal, but no later than January 1, 2026. | ||||
| MAINE | Title 24-A, Chapter 56, § 4237-A - Coverage for screening mammograms and diagnostic and supplemental breast examinations | 6/28/2023 | https://legislature.maine.gov/statutes/24-A/title24-Asec4237-A.html | Mandates that all individual and group health insurance policies provide coverage for screening mammograms, diagnostic breast examinations, and supplemental breast examinations (including breast MRI and ultrasound) without imposing any cost-sharing requirements. Services must be covered when medically necessary, such as for individuals at increased risk of breast cancer due to personal or family medical history or other factors. Applies to policies executed, delivered, issued for delivery, continued, or renewed in Maine. Does not apply to individual or group coverage offered for use with a health savings account unless permitted under federal law. | ||||
| MARYLAND | HB 376 / SB 184 (2023) - Health Insurance - Diagnostic and supplemental exmainations and biopsies for breast cancer - Cost-sharing | 5/3/2023 | https://mgaleg.maryland.gov/mgawebsite/Legislation/Details/HB0376?ys=2023RS | Mandates health insurance plans, including individual, group, and blanket policies, as well as HMOs, to provide coverage for diagnostic and supplemental breast examinations without imposing cost-sharing requirements such as copayments, coinsurance, or deductibles. Applies to diagnostic mammography, breast magnetic resonance imaging (MRI), and breast ultrasound examinations. Specifies that if a patient is covered under a high-deductible health plan (HDHP), the diagnostic and supplemental breast examinations may be subject to the plan's deductible requirements. | ||||
| MASSACHUSETTS | H 4918 (2023-2024) - Relative to medically necessary breast screenings and exams for equity and early detection | 11/13/2024 | https://malegislature.gov/Bills/193/H4918 | Mandates health insurance plans to cover diagnostic breast cancer examinations, digital breast tomosynthesis, and medically necessary screenings using breast magnetic resonance imaging (MRI) or breast ultrasound. Services must be provided without any increase in patient cost-sharing, such as deductibles, copayments, or coinsurance. Applies to both individual and group health insurance policies, including those offered through the Commonwealth's health insurance commission and Medicaid managed care organizations. Effective starting January 1, 2026, for new policies, with existing policies required to comply by January 1, 2027. | ||||
| MICHIGAN | HB 5084 (2023) - Insurance: health insurers; coverage for examinations and medications related to breast cancer | https://legislature.mi.gov/Bills/Bill?ObjectName=2023-HB-5084 | Mandates health insurance policies issued or renewed in Michigan to provide coverage for breast cancer diagnostic services, including breast MRI and ultrasound, without imposing cost-sharing requirements. Applies to both diagnostic and supplemental breast examinations deemed medically necessary, based on individual risk factors such as family history or genetic predisposition. Prohibits insurers from requiring patients to fail on one medication before covering another for advanced metastatic cancer. | Died in committee - Inactive | ||||
| MINNESOTA | 62A.30 - Coverage for diagnostic procedures for cancer | 3/8/2023 | https://www.revisor.mn.gov/statutes/cite/62A.30 | Requires insurer to cover additional diagnostic services or testing where provider deems necessary after a mammogram. Prohibits insurer from imposing cost sharing on diagnostic breast screening. Diagnostic screening includes medically necessary MRI and ultrasound screening. | ||||
| MISSISSIPPI | SB 2858 (2024) - Health benefit plans; set provisions related to diagnostic breast exams and individualized investigational drugs. | 4/22/2024 | https://billstatus.ls.state.ms.us/2024/pdf/history/SB/SB2858.xml | Requires group and individual health insurance plans to provide coverage for screening, diagnostic, and supplemental breast examinations (including breast MRI and ultrasound) without imposing any cost-sharing requirements such as deductibles, copayments, or coinsurance. Services must be provided when medically necessary, based on personal or family medical history, or additional risk factors that may increase the individual's risk of breast cancer. Specifies that if applying this mandate would result in health savings account (HSA) ineligibility under federal law, the requirement applies only to high-deductible health plans after the enrollee has satisfied the minimum deductible, except for preventive care services. Effective immediately. | ||||
| MISSOURI | Chapter 376.782 - Mammography - low-dose screening, defined - health care policies to provide required coverage - no physician referral, when. | 8/28/2023 | https://revisor.mo.gov/main/OneSection.aspx?section=376.782 | Requires insurer to cover additional or supplemental screening, including MRI and ultrasound, where deemed medically necessary by a physician. For any woman with above-average risk, requires insurer to cover ultrasound and MRI screening where deemed medically necessary by a physician. | ||||
| MONTANA | HB 665 (2023) - Revise laws related to insurance coverage of breast examinations | 4/20/2023 | https://laws.leg.mt.gov/legprd/LAW0210W$BSIV.ActionQuery?P_BILL_NO1=665&P_BLTP_BILL_TYP_CD=HB&Z_ACTION=Find&P_SESS=20231 | Requires insurer to cover diagnostic and supplemental breast screening where medically necessary and clinically appropriate. Diagnostic and supplemental screening includes MRI and ultrasound screening. Prohibits cost sharing for diagnostic and supplmental screening. | ||||
| NEBRASKA | LB 1353 (2023-2024) - Change provisions relating to insurance coverage for screening mammography and breast examinations | https://nebraskalegislature.gov/bills/view_bill.php?DocumentID=54693 | Would require coverage of at least one contrast-enhanced mammogram. Would require coverage of additional mammograms if necessary for women 40 or older and ror women with an increased risk, it would require coverage of at least one digital breast tomosynthesis, bilateral whole breast ultrasounds and diagnostic magnetic resonance imaging with additional tomosynthesis, ultrasound or imaging as medically needed. | Indefinitely postponed - Inactive | ||||
| NEVADA | SB 330 (2023) - Revises provisions related to health care. | 6/6/2023 | https://www.leg.state.nv.us/App/NELIS/REL/82nd2023/Bill/10238/Overview | Requires insurer to cover diagnostic screening where deemed medically necessary or to evaluate an abnormality seen in a previous mammogram or otherwise detected. Prohibits cost sharing for diagnostic screening. Effective date: January 1, 2024. | ||||
| NEW HAMPSHIRE | HB 1296 (2024) - Relative to insurance coverage for diagnostic and supplemental breast examinations. | 6/4/2024 | https://gc.nh.gov/bill_status/legacy/bs2016/bill_status.aspx?lsr=2186&sy=2024&sortoption=&txtsessionyear=2024&txtbillnumber=HB1296 | Requires commercial insurance companies that offer coverage of breast diagnostic imaging tests (including MRIs, ultrasounds, diagnostic mammograms, etc.) to eliminate patient cost-sharing (deducitble, coinsurance, copayment, or similar out-of-pocket expenses). This applies to preventative screenings and both supplemental screening and diagnostic exams when an abnormality is found. Effective date: January 1, 2025. | ||||
| NEW JERSEY | A 5542 (2024-2025) - Requires health insurance coverage of diagnostic and supplemental breast examinations without cost-sharing. | https://www.njleg.state.nj.us/bill-search/2024/A5542 | Would require health insurance plans (including group and individual hospital service corporation contracts) to cover diagnostic and supplemental breast examinations without imposing cost-sharing requirements such as deductibles, coinsurance, or copayments. Diagnostic breast examinations encompass medically necessary procedures like breast MRI and ultrasound, as outlined by NCCN guidelines. Supplemental breast examinations are defined as medically necessary screenings, including breast MRI and ultrasound, for individuals at increased risk of breast cancer due to factors such as personal or family medical history or dense breast tissue. Applies to new or renewed policies issued on or after the effective date, with provisions extending to high-deductible health plans to the maximum extent permitted by federal law. | Referred to committee - Active | ||||
| NEW MEXICO | HB 27 (2023) - Breast Exam Health Coverage | 3/18/2023 | https://www.nmlegis.gov/Legislation/Legislation?chamber=H&legtype=B&legno=27&year=23 | Mandates individual and group health insurance policies, including HMOs, to provide coverage for diagnostic and supplemental breast examinations (such as breast MRI and ultrasound) without imposing cost-sharing requirements like deductibles, copayments, or coinsurance. Diagnostic breast examinations are defined as medically necessary procedures to evaluate abnormalities detected through screening or other means, while supplemental breast examinations refer to screenings for individuals at increased risk of breast cancer due to factors like personal or family medical history. Does not apply to excepted benefit plans, catastrophic plans, or high-deductible health plans with health savings accounts until the deductible is met, unless permitted under federal law. Effective immediately. | ||||
| NEW YORK | S8093 (2016) - Relates to coverage for the detection of breast cancer, requiring certified mammography facilities to provide extended hours and excused leave to undertake a breast cancer screening | 6/12/2016 | https://legislation.nysenate.gov/pdf/bills/2015/S8093 | Prohibits insurer from imposing cost sharing on covered diagnostic breast screening beyond a screening mammogram. Diagnostic screening includes medically necessary MRI and ultrasound screening. | ||||
| NORTH CAROLINA | SB 553 (2025-2026) - Save More Tatas Act | https://www.ncleg.gov/BillLookUp/2025/S553 | Would require health benefit plans (including individual, group, and preferred provider plans) to cover diagnostic and supplemental breast cancer examinations, such as breast MRI and ultrasound, without imposing cost-sharing requirements like deductibles, copayments, or coinsurance. Services must be provided when medically necessary, based on factors like personal or family medical history or dense breast tissue. Would mandate that the cost-sharing terms for these examinations are no less favorable than those for low-dose screening mammography. Proposed effectived date: October 1, 2025, for new or renewed policies. | Referred to committee - Active | ||||
| NORTH DAKOTA | HB 1283 (2025-2026) - Diagnostic breast examination and supplemental breast examination cost-sharing restrictions | https://ndlegis.gov/assembly/69-2025/regular/bill-overview/bo1283.html | Would mandate health insurance coverage provided by the Public Employees Retirement System (PERS) to cover diagnostic and supplemental breast examinations (including breast MRI and ultrasound) without imposing cost-sharing requirements such as deductibles, copayments, or coinsurance. Diagnostic breast examinations are defined as medically necessary procedures to evaluate abnormalities detected through screening or other means, while supplemental breast examinations refer to screenings for individuals at increased risk of breast cancer due to factors like personal or family medical history. Would apply to new or renewed policies issued on or after the effective date, with provisions extending to high-deductible health plans to the maximum extent permitted by federal law. | Died in chamber - Inactive | ||||
| OHIO | HB 371 (2021-2022) - Regards screening mammography and dense breast tissue | 6/1/2022 | https://www.legislature.ohio.gov/legislation/legislation-summary?id=GA134-HB-371 | Requires health insurance policies (including individual, group, and Medicaid plans) to cover screening mammography and supplemental breast cancer screenings, such as breast MRI and ultrasound, without imposing cost-sharing requirements like deductibles, copayments, or coinsurance. Supplemental screenings are defined as additional methods deemed medically necessary by a health care provider, in accordance with ACR guidelines. Mandates that women with dense breast tissue or increased breast cancer risk be informed about their condition and the availability of supplemental screening options. Applies to policies delivered, issued for delivery, or renewed on or after September 23, 2022. | ||||
| OKLAHOMA | HB 3504 (2022) - Health insurance; definitions; mammography; effective date | 5/20/2022 | http://www.oklegislature.gov/BillInfo.aspx?Bill=hb3504&Session=2200 | Requires health benefit plans (including individual, group, and Medicaid plans) to cover diagnostic and supplemental breast cancer examinations, such as breast MRI and ultrasound, without imposing cost-sharing requirements like deductibles, copayments, or coinsurance. Services must be provided when medically necessary, based on factors like personal or family medical history or dense breast tissue. Mandates that the cost-sharing terms for these examinations are no less favorable than those for low-dose screening mammography. Effective date: November 1, 2022. | ||||
| OREGON | SB 1041 (2023) -Relating to health insurance coverage of breast examinations | 8/3/2023 | https://olis.oregonlegislature.gov/liz/2023R1/Measures/Overview/SB1041 | Requires health insurance carriers (including individual and group plans) to cover diagnostic and supplemental breast examinations, such as breast MRI and ultrasound, without imposing cost-sharing requirements like deductibles, copayments, or coinsurance. Diagnostic breast examinations are defined as evaluations of breast abnormalities detected through screening or other means, utilizing methods like diagnostic mammography, breast MRI, or breast ultrasound. Supplemental breast examinations refer to screenings for individuals at increased risk of breast cancer due to factors like personal or family medical history or dense breast tissue. Applies to policies issued or renewed on or after January 1, 2024. | ||||
| PENNSYLVANIA | SB 595 (2019-2020) - In casualty insurance, further providing for coverage for mammographic examinations. | 7/1/2020 | https://www.legis.state.pa.us/cfdocs/billinfo/bill_history.cfm?syear=2019&sind=0&body=S&type=B&bn=595 | Requires health insurance policies (including individual, group, and Medicaid plans) to cover breast MRI and ultrasound screenings for women with high-risk factors for breast cancer, such as extremely dense breast tissue, personal or family history of breast cancer, genetic predisposition, or prior therapeutic thoracic radiation therapy. Mandates that these screenings be provided without cost-sharing requirements like deductibles, copayments, or coinsurance. Effective as existing insurance policies expire, with full implementation beginning January 1, 2022. | ||||
| *PUERTO RICO | P.R. Laws tit. 24, § 3072 - Cancer Patients and Survivors' Bill of Rights | 2012 | https://law.justia.com/codes/puerto-rico/title-twenty-four/part-vii/chapter-132a/3072 | Requires insurer to cover, for cancer patients and surviviors, screening including MRI and ultrasound. | ||||
| RHODE ISLAND | HB 5283 (2023) - Accident And Sickness Insurance Policies -- Mammograms And Pap Smears -- Coverage Mandated | 6/24/2023 | https://webserver.rilegislature.gov/BillText/BillText23/HouseText23/H5283A.pdf | Mandates that health insurance policies (including individual, group, and nonprofit hospital or medical service plans) cover diagnostic and supplemental breast cancer screenings, such as breast MRI and ultrasound, without cost-sharing requirements like deductibles, copayments, or coinsurance. Applies to individuals who have received notice of dense breast tissue. Requires coverage for 2 screening mammograms per year for women who have been treated for breast cancer within the last 5 years or are at high risk of developing breast cancer due to genetic predisposition (e.g., BRCA gene mutation or multiple first-degree relatives) or high-risk lesions on prior biopsy (e.g., lobular carcinoma in situ or atypical ductal hyperplasia). Effective date: January 1, 2024. | ||||
| SOUTH CAROLINA | HB 3202 (2025-2026) - Diagnostic and supplemental breast examination insurance | https://www.scstatehouse.gov/billsearch.php?billnumbers=3202&session=126&summary=B | Would require health insurance policies to cover diagnostic and supplemental breast examinations, including breast MRI and ultrasound, without cost-sharing requirements such as deductibles, copayments, or coinsurance. Diagnostic breast examinations are defined as medically necessary evaluations to assess abnormalities detected through screening or other means, utilizing methods like contrast-enhanced mammography, diagnostic mammography, breast MRI, breast ultrasound, or molecular breast imaging. Supplemental breast examinations refer to screenings for individuals at increased risk of breast cancer due to factors like personal or family medical history or dense breast tissue, even in the absence of abnormalities. Includes provisions to ensure compliance with federal laws concerning Health Savings Accounts and preventive care. | Died in committee - Inactive | ||||
| SOUTH DAKOTA | HB 1070 (2025) - Prohibit cost sharing in certain health insurance policies for diagnostic and supplemental breast imaging examinations | https://sdlegislature.gov/#/Session/Bill/25489 | Requires a health insurance policy to not impose any cost-sharing requirements with respect to screening, diagnostic breast examinations, and supplemental breast examinations furnished regardless of preconditions or abnormalities as long as deemed medically necessary. | Died in chamber - Inactive | ||||
| TENNESSEE | HB0355 (2023) - An Act to amend Tennessee Code Annotated, Title 56, Chapter 7, relative to coverage for breast examinations. | 6/2/2023 | https://wapp.capitol.tn.gov/apps/Billinfo/default.aspx?BillNumber=HB0355&ga=113 | Requires health benefit plans (including individual, group, and Medicaid plans) to cover diagnostic and supplemental breast examinations, such as breast MRI and ultrasound, without imposing cost-sharing requirements like deductibles, copayments, or coinsurance. Diagnostic breast examinations are defined as medically necessary evaluations to assess abnormalities detected through screening or other means, utilizing methods like contrast-enhanced mammography, diagnostic mammography, breast MRI, breast ultrasound, or molecular breast imaging. Supplemental breast examinations refer to screenings for individuals at increased risk of breast cancer due to factors like personal or family medical history or dense breast tissue, even in the absence of abnormalities. Includes provisions to ensure compliance with federal laws concerning Health Savings Accounts and preventive care. Effective date: August 9, 2023. | ||||
| TEXAS | HB 170 (2019-2020) - Relating to coverage for mammography under certain health benefit plans | 6/15/2019 | https://capitol.texas.gov/BillLookup/History.aspx?LegSess=86R&Bill=HB170 | Requires any insurer who provides coverage for a screening mammogram to impose cost sharing for diagnostic screening that is no less favorable than cost sharing applicable to a screening mammogram. Diagnostic screening includes MRI or ultrasound designed to evaluate a seen or identified abnormality. Effective date: September 1, 2019. | ||||
| UTAH | HB 314 (2025) - Breast Cancer Prevention Modifications | https://le.utah.gov/~2025/bills/static/HB0314.html | Would require health benefit plans (including individual, group, and Medicaid plans) to cover diagnostic and supplemental breast examinations, such as breast MRI and ultrasound, without imposing cost-sharing requirements like deductibles, copayments, or coinsurance. Diagnostic breast examinations are defined as medically necessary evaluations to assess abnormalities detected through screening or other means, utilizing methods like contrast-enhanced mammography, diagnostic mammography, breast MRI, breast ultrasound, or molecular breast imaging. Supplemental breast examinations refer to screenings for individuals at increased risk of breast cancer due to factors like personal or family medical history or dense breast tissue, even in the absence of abnormalities. Includes provisions to ensure compliance with federal laws concerning Health Savings Accounts and preventive care. | Bill not passed | ||||
| VERMONT | H.621 (2023-2024) - An act relating to health insurance coverage for diagnostic breast imaging | 4/25/2024 | https://legislature.vermont.gov/bill/status/2024/H.621 | Requires health plans to cover other medically necessary breast imaging services upon recommendation of a health care provider as needed to detect the presence of breast cancer and other abnormalities of the breast or breast tissue. The plan must cover the full cost of the imaging service without any patient cost-sharing, except to the extent that such coverage would cause a high-deductible health plan to lose its eligibility for a HSA under federal law. | ||||
| VIRGINIA | HB 1828 (2025) / SB 1436 (2025) - Health insurance; cost sharing for breast examinations. | 3/24/2025 | https://lis.virginia.gov/bill-details/20251/HB1828 | Requires health insurance policies, including individual, group, and Medicaid plans, to cover diagnostic and supplemental breast examinations (such as breast MRI and ultrasound) without imposing cost-sharing requirements like deductibles, copayments, or coinsurance. Diagnostic breast examinations are defined as medically necessary evaluations to assess abnormalities detected through screening or other means, utilizing methods like contrast-enhanced mammography, diagnostic mammography, breast MRI, breast ultrasound, or molecular breast imaging. Supplemental breast examinations refer to screenings for individuals at increased risk of breast cancer due to factors like personal or family medical history or dense breast tissue, even in the absence of abnormalities. Includes provisions to ensure compliance with federal laws concerning Health Savings Accounts and preventive care. | ||||
| WASHINGTON | SB 5396 (2023-2024) - Concerning cost sharing for diagnostic and supplemental breast examinations | 5/9/2023 | https://app.leg.wa.gov/billsummary?BillNumber=5396&Year=2023&Initiative=false | Requires health insurance policies, including individual, group, and Medicaid plans, to cover diagnostic and supplemental breast examinations (such as breast MRI and ultrasound) without imposing cost-sharing requirements like deductibles, copayments, or coinsurance. Diagnostic breast examinations are defined as medically necessary evaluations to assess abnormalities detected through screening or other means, utilizing methods like diagnostic mammography, digital breast tomosynthesis, breast MRI, or breast ultrasound. Supplemental breast examinations refer to screenings for individuals at increased risk of breast cancer due to factors like personal or family medical history or dense breast tissue, even in the absence of abnormalities. Includes provisions to ensure compliance with federal laws concerning HSAs and preventive care. Effective date: July 23, 2023. | ||||
| WEST VIRGINIA | SB 156 (2025) - Providing diagnostic and supplemental breast examinations without cost sharing | http://www.wvlegislature.gov/Bill_Status/Bills_history.cfm?input=156&year=2025&sessiontype=RS&btype=bill | Requires health insurance policies, including individual, group, and Medicaid plans, to cover diagnostic and supplemental breast examinations (such as breast MRI and ultrasound) without imposing cost-sharing requirements like deductibles, copayments, or coinsurance. Diagnostic breast examinations are defined as medically necessary evaluations to assess abnormalities detected through screening or other means, utilizing methods like contrast-enhanced mammography, diagnostic mammography, breast MRI, breast ultrasound, or molecular breast imaging. Supplemental breast examinations refer to screenings for individuals at increased risk of breast cancer due to factors like personal or family medical history or dense breast tissue, even in the absence of abnormalities. Includes provisions to ensure compliance with federal laws concerning HSAs and preventive care. | Died in committee - Inactive | ||||
| WISCONSIN | SB 264 (2025-2026) / AB 263 (2025-2026) - Coverage of breast cancer screenings by the Medical Assistance program and health insurance policies and plans. | https://docs.legis.wisconsin.gov/2025/proposals/reg/sen/bill/sb264 | Would require health insurance policies and self-insured health plans to cover diagnostic and supplemental breast examinations, such as breast MRI and ultrasound, without imposing cost-sharing requirements like deductibles, copayments, or coinsurance. Diagnostic breast examinations are defined as medically necessary evaluations to assess abnormalities detected through screening or other means, utilizing methods like contrast-enhanced mammography, diagnostic mammography, breast MRI, breast ultrasound, or molecular breast imaging. Supplemental breast examinations refer to screenings for individuals at increased risk of breast cancer due to factors like personal or family medical history or dense breast tissue, even in the absence of abnormalities. Includes provisions to ensure compliance with federal laws concerning HSAs and preventive care. | Introduced May 20, 2025 - Active | ||||
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| GUAM | Public Law 34-109 - Relative to Providing Breast Cancer Screening Coverage in Health Insurance Benefit Plans Sold on Guam, and by Medicaid and the Medically Indigent Program (MIP). | 5/5/2018 | https://archives.guamlegislature.gov/public-laws/ | Mandates health insurance providers on Guam to cover low-dose mammograms for breast cancer screening. Requires coverage for a baseline mammogram for women aged 35 to 39, annual mammograms for women40 and older, and for men and women with a history of breast cancer, according to the health care provider's recommendation. Effective date: For insurance policies renewed or issued after January 1, 2018. | ||||
| Last updated | 9/2025 |