This chart summarizes state laws requiring insurance coverage for screening mammograms. Federal law also requires most commercial health plans to cover screening mammograms for women ages 40–74 without cost-sharing. Depending on the state and the type of health plan, either federal or state law may provide more generous coverage protections.
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| State | Statute | Type of Insurance Covered by Statute | Age for a Baseline Mammogram | Age for Bi-Annual Mammograms | Age for Annual Mammograms | Exceptions to Age or Frequency | Cost share for Mammogram per State Law | |
|---|---|---|---|---|---|---|---|---|
| ALABAMA | AL ST § 27-50-4; 27-50-7 | https://alison.legislature.state.al.us/code-of-alabama | Commercial Contracts (including self-insured health plans) and Medicaid | 40 | 40-49 | 50 or Older | More frequently if recommended by a physician. | Not specified in Statute |
| ALASKA | AS § 21.42.375 | https://www.akleg.gov/basis/statutes.asp#21.42.375 | Commercial Contracts Only (Except Fraternal Benefit Societies) | 35-39 | 40-49 | 50 or Older | No age limitation for someone with a history of breast cancer or whose parent or sibling has a history of breast cancer, upon referral by a physician | Not subject to deductibe, copayment and coinsurance (except high deductible health plans) |
| ARIZONA | AZ ST 20-1057(J); S.B. 1601 | https://legiscan.com/AZ/text/SB1601/2023#:~:text=J.-,A%20contract%20that%20provides%20coverage%20for%20surgical%20services%20for%20a%20mastectomy,IMAGING%20REPORTING%20AND%20DATA%20SYSTEM%20OF%20THE%20AMERICAN%20COLLEGE%20OF%20RADIOLOGY.,-K.%20Any%20contract | Commerical Contracts Only | Not specified in Statute | Not specified in Statute | Not specified in Statute | No age limitation if deemed medically necessary by health care provider | Not specified in Statute |
| ARKANSAS | AR Code § 23-79-140(b)-(c) | https://law.justia.com/codes/arkansas/title-23/subtitle-3/chapter-79/subchapter-1/section-23-79-140/ | Commercial Contracts Only (including self-insured governmental or church plans) | 35-40 | Not specified in Statute | 40 or Older | No age limitation for women who have a prior history of breast cancer, when the woman's mother, sister, or any first- or second-degree female relative has had a history of breast cancer, positibve genetic testing, or other risk factors | Not subject to copayments or deductibles; diagnostic exams cannot have higher cost-sharing than screening exams |
| CALIFORNIA | Cal. HSC § 1367.65 (Amended) & § 1367.002 ; CA WEL & INST 14132.16 | https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?sectionNum=1367.65.&lawCode=HSC | Commercial Contracts and Medicaid | Not specified in Statute | Not specified in Statute | Not specified in Statute | No age limitation with referral from a participating NP, CNM, PA, or physician | Group or individual nongrandfathered health care service plan contracts cannot impose any cost-sharing requirements |
| COLORADO | CO ST 10-16-104; HB 1301 (Amended 05/16/2019); SB 296 enacted 5/29/2025 | https://codes.findlaw.com/co/title-10-insurance/co-rev-st-sect-10-16-104/?utm_source=chatgpt.com#:~:text=(b.5)(I,risk%20assessment%20models. | Commercial Contracts Only | 40 | Not specified in Statute | 40 or older | At any age if a family history of breast cancer or has an incrase lifetime risk of breast cancer | Not subject to cost-sharing |
| CONNECTICUT | C.G.S.A. § 38a-503 | https://www.cga.ct.gov/2025/pub/chap_700c.htm#sec_38a-503 | Commerical Contracts Only | 35-39 | Not specified in Statute | 40 or Older | No age limitation for women who are high risk and mammmogram is recommended by physician. | Not subject to copayments, deductibles, or conisurance |
| DELAWARE | 18 Del.C. § 3552, 18 Del.C. § 3370F, 16 Del. Admin. Code 5100-14920. | https://delcode.delaware.gov/title18/c035/sc03/index.html | Commerical Contracts Only | 35-39 | Not specified in Statute | 40 or Older | No age limitation for women who are high risk and mammmogram is recommended by physician. | Subject to copayments, deductibles, or conisurance |
| DISTRICT OF COLUMBIA | D.C. Code § 31-2902 | https://code.dccouncil.gov/us/dc/council/code/sections/31-2902 | Commercial Contracts and Medicaid | Not specified in Statute | Not specified in Statute | Not specified in Statute | Not specified in Statute | Not subject to co-payment except when performed by an out-of-network provider |
| FLORIDA | F.S.A. § 627.6418 | https://www.leg.state.fl.us/Statutes/index.cfm?App_mode=Display_Statute&Search_String=&URL=0600-0699/0627/Sections/0627.6418.html | Commercial Contracts Only | 35-39 | 40-49 | 50 or Older | More frequently if recommended by a physician for a woman who is at higher risk | Subject to copayments, deductibles, or conisurance |
| GEORGIA | Ga. Code § 33-29-3.2; 33-30-4.2, HB 937. | https://law.justia.com/codes/georgia/title-33/chapter-29/section-33-29-3-2/ | Commercial Contracts Only | 35-39 | 40-49 | 50 or Older | More frequently and no age limitation if ordered by a physician for a female at risk | Subject to copayments, deductibles, or conisurance |
| HAWAII | HRS § 431:10A-116,HRS § 432:1-605) | https://law.justia.com/codes/hawaii/title-24/chapter-431/section-431-10a-116/ | Commercial Contracts Only | 40 | Not specified in Statute | 40 or Older | No age limitation for women with a history of breast cancer or whose mother or sister has had a history of breast cancer, upon recommendation of a physician | Subject to conisurance; statute is silent about other costs |
| IDAHO | HB134,§ 41-2144 | https://law.justia.com/codes/idaho/title-41/chapter-21/section-41-2144/ | Commercial Contracts Only | 35-39 | 40-49 | 50 or Older | More frequently than bi-annual for women age 40-49, if recommended by physician. No age limitation for medical cause. | Subject to copayments, deductibles, or conisurance; as of 1/1/2026, HB 134 requires health benefit plans to provide one supplemental breast screening every year for someone at increased risk of breast cancer at no cost |
| ILLINOIS | 215 ILCS 5/356g, 215 ILCS 125/4-6.1, 65 ILCS 5/10-4-2,55 ILCS 5/5-1069). | https://www.ilga.gov/documents/legislation/ilcs/documents/021500050k356g.htm | Commerical Contracts Only | 35-39 | Not specified in Statute | 40 or Older | At any age or frequency if medically necessary for patient under 40 whoh as a family history of breast cancer, prior personal history of breast cancer, positive genetic testing, or other risk factors | Not subject to deductibles, copayments, or coinsurances |
| INDIANA | IN Code §27-8-14-6 | https://iga.in.gov/laws/2025/ic/titles/27#27-8-14-6 | Commercial Contracts Only | 35-39 | Not specified in Statute | 40 or Older; under 40 & at risk | At any age if woman is at risk | Subject to copayments, deductibles, or conisurance. |
| IOWA | C.A. § 514C.4 | https://www.legis.iowa.gov/docs/code/514C.4.pdf | Commercial Contracts Only | 35-39 | 40-49 | 50 or Older | More frequently if recommended by a physician. | Subject to copayments, deductibles, or conisurance |
| KANSAS | K.S.A. § 40-2229, 40-2230 (repealed), SB-409 | https://www.kslegislature.gov/li_2012/b2011_12/measures/documents/sb253_00_0000.pdf | Commercial Contracts Only | Not specified in Statute | Not specified in Statute | Not specified in Statute | At any age so long as ordered by a physician | Subject to copayments, deductibles, or conisurance (Pending SB 409 could change this) |
| KENTUCKY | K.Y. § 304.17-316, K.Y. §304.18-098 | https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=55750 | Commercial Contracts Ony | 35-39 | 40-49 | 50 or Older | At any age if diagnosed with breast disease upon referral by a health care practitioner | Subject to copayments, deductibles, or conisurance |
| LOUISIANA | RS § 22:1028 | https://legis.la.gov/Legis/Law.aspx?p=y&d=507868 | Commercial Contracts Only | 35-39 | Not specified in Statute | 40 or Older; 35 or older upon physician recommendation (if predicted lifetime risk at a certain level) | Annual mammograms starting at age 30 for women with a hereditary susceptibility from pathogenic mutation carrier status or prior chest wall radiation | Not subject to deductibles. |
| MAINE | M.E. Ins. Code. §2837 | https://legislature.maine.gov/statutes/24-a/title24-Asec2837-A.html | Commercial Contracts Only | Not specified in Statute | Not specified in Statute | 40 or Older | Not specified in Statute | Not subject to copays, deductibles, or conisurance |
| MARYLAND | M.D. Ins. Code §§ 15-814; 15-907 | https://law.justia.com/codes/maryland/insurance/title-15/subtitle-8/section-15-814/ | Commercial Contracts Only | Not specified in Statute | Not specified in Statute | Not specified in Statute | Coverage is in accordance with the latest screening guidelines issued by the American Cancer Society and includes coverage when medically necessary as determined by a physician | Not subject to deductibles, but may be subject to copayments and coinsurance |
| MASSACHUSETTS | MA ST 175 § 47G; 47ZZ | https://malegislature.gov/Laws/GeneralLaws/PartI/TitleXXII/Chapter175/Section47G | Commercial Contracts Only | 35-39 | Not specified in Statute | 40 or Older | Not specified in Statute | Subject to deductibles, copayments and coinsurance |
| MICHIGAN | MCL § 500.3406d | https://www.legislature.mi.gov/Laws/MCL?objectName=mcl-500-3406d | Commercial Contracts Only | 35-39 | Not specified in Statute | 40 or Older | Not specified in Statute | Subject to deductibles, copayments and coinsurance. |
| MINNESOTA | M.S.A. § 62A.30 | https://www.revisor.mn.gov/statutes/cite/62a.30 | Commercial Contracts Only | Not specified in Statute | Not specified in Statute | Not specified in Statute | Mammograms must be covered for those who are at risk for breast cancer | Subject to deductibe, copayment and coinsurance, but additional diagnostic services after initial mammogram are not |
| MISSISSIPPI | Miss. Code Ann. § 83-9-108; 83-9-403(2) | https://advance.lexis.com/documentpage/?pdmfid=1000516&crid=40698cd0-b068-4b0c-8096-6b5e698b51d0&config=00JABhZDIzMTViZS04NjcxLTQ1MDItOTllOS03MDg0ZTQxYzU4ZTQKAFBvZENhdGFsb2f8inKxYiqNVSihJeNKRlUp&pddocfullpath=%2Fshared%2Fdocument%2Fstatutes-legislation%2Furn%3AcontentItem%3A6BWS-CJN3-RSCG-S2WP-00008-00&pdcontentcomponentid=234190&pdteaserkey=sr0&pditab=allpods&ecomp=6s65kkk&earg=sr0&prid=a224d0ee-d160-4226-8f51-2d4f21596b09 | Commercial Contracts Only | 35 (Optional Coverage under Medicare Supplemental Insurance Only); no age specified for other types of policies | Not specified in Statute | 35 or Older (Optional Coverage under Medicare Supplemental Insurance Only); no age specified for other types of policies | No age or frequency limitations set in Statute for commercial contracts that are not Medicare Supplmental Plans | Not subject to subject to deductibles, copayments and coinsurance, except Medicare Supplemental Insurance |
| MISSOURI | V.A.M.S. 376.782 | https://revisor.mo.gov/main/OneSection.aspx?section=376.782#:~:text=The%20section%20also%20requires%20that:%20*%20Coverage,least%20as%20favorable%20as%20other%20radiological%20examinations | Commercial Contracts Only | 35-39 | Not specified in Statute | 40 or Older | Not age limitation for women who are high risk. | Subject to deductibles or copayments |
| MONTANA | MCA33-22-132 | https://mca.legmt.gov/bills/mca/title_0330/chapter_0220/part_0010/section_0320/0330-0220-0010-0320.html | Commercial Contracts Only | 35-39 | 40-49 | 50 or Oler | More frequently if recommended by a physician. | Minimum $70 payment or actual charge, whichever is less, before subject to deductibles, copayments and coinsurance |
| NEBRASKA | Neb.Rev.St. § 44-785 | https://nebraskalegislature.gov/laws/statutes.php?statute=44-785 | Commercial Contracts Only, including self-funded plans to the extent they aren't preempted by federal law | 35-39 | Not specified in Statute | 40 or Older | Annually at any age based on National Comprehensive Cancer Network Guidelines and recommendation of health care provider due to increased risk. | Not subject to copays or deductibles but execeptions apply |
| NEVADA | NRS 689A.0405 | https://www.leg.state.nv.us/nrs/nrs-689a.html#NRS689ASec04045:~:text=%C2%A0%C2%A0%C2%A0%C2%A0%C2%A0%20NRS%E2%80%82689A.0405%E2%80%82%E2%80%82Coverage%20for%20certain%20screenings%20and%20tests%20for%20breast%20cancer%20required%3B%20prohibited%20acts. | Commercial Contracts Only | 40 | Not specified in Statute | 40 or Older | At any age and frequency when medically necessary and recommended by physician based on history and risk factors. | Not subject to deductibles, coinsurance and other limitation to other covered services |
| NEW HAMPSHIRE | RSA 417-D:2, 417-D:2-c | https://law.justia.com/codes/new-hampshire/title-xxxvii/chapter-417-d/section-417-d-2/ | Commercial Contracts Only | 35-39 | 40-49 (every one-two years) | 50 or Older | Not specified in Statute | Not subject to copays, deductibles, or conisurance |
| NEW JERSEY | NJ ST 17B:27-46.1f | https://lis.njleg.state.nj.us/nxt/gateway.dll?f=templates&fn=default.htm&vid=Publish:10.1048/Enu | Commercial Contracts Only | 40 | Not specified in Statute | 40 or Older | No age or frequency limitation for women who are high risk, if deemed medically necssary by health care provider | No information available |
| NEW MEXICO | NM Stat § 59A-46-41 , N.M. HB27. | https://law.justia.com/codes/new-mexico/chapter-59a/article-22/section-59a-22-39/ | Commercial Contracts Only | 35-39 | 40-49 | 50 or Older | Not specified in Statute | No information available |
| NEW YORK | NY INS § 3216, 3221, 4303 | https://www.dfs.ny.gov/industry_guidance/circular_letters/cl2016_02 | Commercial Contracts Only | 35-39 | Not specified in Statute | 40 or Older | No age limitations for someone with a prior history of breast cancer or a first-degree relative with a prior history of breast cancer, when recommended by a physician | Not subject to deductibles, or conisurance |
| NORTH CAROLINA | N.C.G.S.A § 58‑51‑57 | https://www.ncleg.gov/EnactedLegislation/Statutes/HTML/BySection/Chapter_58/GS_58-51-57.html | Commercial Contracts Only | 35-39 | 40-49 | 50 or Older | More often if recommended by a physician for any woman at high risk | Subject to deductibles, copayments and coinsurance |
| NORTH DAKOTA | NDCC § 26.1-36-09.1 | https://ndlegis.gov/cencode/t26-1c36.pdf | Commercial Contracts Only | 35-39 | Not specified in Statute | 40 or Older | Women age 40 or older can have more than one mammogram per year if recommended by a physician | Not specified in Statute |
| OHIO | R.C.§ 3923.54 | https://codes.ohio.gov/ohio-revised-code/section-3923.54 | Commercial Employer-Provided Contracts Only | 35-39 | 40-49 | 50-64 | Annual mammograms for a woman age 40-49 if physician has determined the woman has risk factors | Not specified in Statute; employer can provide coverage either by offering health insurance or by reimbursing the employee for the direct health care provider charges associated with receiving the services |
| OKLAHOMA | 36 Okl.St.Ann. § 6060 amended HB 1389 | https://www.oklegislature.gov/osstatuestitle.aspx | Commercial Contracts Only | 35-39 | Those ages 35-39 are entitled to a screening mammogram every 5 years | 40 or Older | Not specified in Statute | Not subject to copays, deductibles, or conisurance |
| OREGON | O.R.S. § 743A.100 | https://oregon.public.law/statutes/ors_743a.100 | Commercial Contracts Only | 40 | Not specified in Statute | 40 or Older | More frequently if determined to be at high risk for breast cancer by health care provider | Not specified in Statute |
| PENNSYLVANIA | §632 (40 P.S. §764c) Amended by HB 433 | https://codes.findlaw.com/pa/title-40-ps-insurance/pa-st-sect-40-764c/ | Commercial Contracts Only | 40 | Not specified in Statute | Not specified in Statute | Under the age of 40 if recommended by physician | Not subject to copays, deductibles, or conisurance |
| PUERTO RICO | PR Laws tit. 1, § 3998a | https://law.justia.com/codes/puerto-rico/2020/titulo-24/parte-vii/capitulo-176/3998a/?utm_source=chatgpt.com | Commercial Contracts and Medicaid | 35-39 | Not specified in Statute | 40 or Older | Annual mammogram, follow-up treatment, or supplemental diagnostic tests for women at high risk due to family hjistory, personal history as a cancer patient, high-risk markers in their genetic profile, or any other factor determined by their physician | Not specified in Statute |
| RHODE ISLAND | Title 27. Insurance § 27-18-41 | https://law.justia.com/codes/rhode-island/title-27/chapter-27-18/section-27-18-41/ | Commercial Contracts Only | Not specified in Statute | Not specified in Statute | Not specified in Statute | Two screening mammograms per year when recommended by a physician for women that: a) have been treated for breast cancer in last 5-years; or b) are at high risk of breast cancer | Not specified in Statute |
| SOUTH CAROLINA | SC Code § 38-71-145 | https://www.scstatehouse.gov/Archives/CodeofLaws2000/t38c071.php#:~:text=the%20legal%20obligations.-,SECTION%2038%2D71%2D145,-.%20Required%20coverage | Commercial Contracts Only | 35-39 | 40-49 | 50 or older | In accordance with the most recent published guidelinse of the American Cancer Society | Subject to deductibles, copayments and coinsurance |
| SOUTH DAKOTA | SDCL § 58-17-1.1 | https://sdlegislature.gov/Statutes/58-17-1.1 | Commercial Contracts Only | 35-39 | 40-49 | 50 or Older | Not specified in Statute | Subject to deductibles, copayments and coinsurance |
| TENNESSEE | TN Code § 56-7-2502, HB0355, HB0365 | https://law.justia.com/codes/tennessee/title-56/chapter-7/part-25/section-56-7-2502/ | Commercial Contracts Only | 35-40 | Not specified in Statute | 35-40 if at risk, or 40 and Older based on physician recommendation | Not specified in Statute | Not subject to copays, deductibles, or conisurance |
| TEXAS | V.T.C.A., Insurance Code § 1356.005 | https://statutes.capitol.texas.gov/?tab=1&code=IN&chapter=IN.1356&artSec= | Commercial Contracts; Medicaid | 35 | Not specified in Statute | 35 or Older | Not specified in Statute | Subject to deductibles, copayments and coinsurance |
| UTAH | None | None | None | None | None | None | None | None |
| VERMONT | 8 V.S.A. § 4095b | https://legislature.vermont.gov/statutes/section/08/107/04095b | Commercial Contracts Only | Not specified in Statute | Not specified in Statute | Not specified in Statute | Not specified in Statute | Not subject to copayments, deductibles, or conisurance |
| VIRGINIA | VA Code Ann. § 38.2-3418.1 | https://law.lis.virginia.gov/vacode/title38.2/chapter34/section38.2-3418.1/#:~:text=Such%20coverage%20shall%20make%20available,per%20mammogram%20subject%20to%20such | Commercial Contracts Only | 35-39 | 40-49 | 50 or Older | Not specified in Statute | May be limited to a benefit of $50 per mammogram, subject to deductibles, copayments and coinsurance |
| WASHINGTON | RCW 48.43.076 (Effective until 6/20/2027) | https://app.leg.wa.gov/RCW/default.aspx?cite=48.21.225 | Commercial Contracts Only | Not specified in Statute | Not specified in Statute | Not specified in Statute | Must be upon recommendation of physician or advanced registered nurse practitioner | Not specified in Statute |
| WEST VIRGINIA | W. Va. Code, § 16-3G | https://code.wvlegislature.gov/33-16-3G/ | Commercial Contracts Only | Not specified in Statute | Not specified in Statute | Not specified in Statute | When medically appropriate and consistent with the current guidelines from the USPSTF | Subject to deductibles, coinsurance and other limitations as apply to other covered services |
| WISCONSIN | W.S.A. 632.895(8)(b)). | https://docs.legis.wisconsin.gov/statutes/statutes/632/vi/895/8/b | Commercial Contracts Only | 45-49 | 45-49 | 50 or Older | Covers two exams when a woman is age 45 to 49, if the woman has not had an exam wtihin past two years | Subject to deductibles, copayments and coinsurance |
| WYOMING | W.S.1977 § 26-19-107 | https://wyoleg.gov/2000/bills/HB0026.htm | Commercial Contracts Only, including self-funded plans to the extent they aren't preempted by federal law | Not specified in Statute | Not specified in Statute | Not specified in Statute | Not specified in Statute | Not subject to deductible, but may be subject to copayment of up to $25. |
| GUAM | Public Law 34-109 | https://archives.guamlegislature.gov/34th_Guam_Legislature/Public_Laws_34th/P.L.%20No.%2034-109.pdf | Commercial Contracts and Medicaid | 35-39 | N/A | 40 or Older | Performed as recommended by physician (but not more than one annually) for a woman of any age, and for men age 40 or older, who have a first-degree blood relative that was diagnosed to have developed breast cancer at 40 or younger | Not subject to coinsurance or deductibles |
| LAST UPDATE | 6/25/2026 | 6/25/2026 | 6/25/2026 | 6/25/2026 | 6/25/2026 | 6/25/2026 | 6/25/2026 |