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Eliminating Out-of-Pocket Costs for Diagnostic and Supplemental Breast Exams.

This law prohibits health insurance plans from charging patients any out-of-pocket costs, such as deductibles or copayments, for medically necessary diagnostic and supplemental breast examinations. This change removes financial barriers for individuals needing crucial follow-up tests like diagnostic mammograms, MRIs, or ultrasounds after a screening or due to high-risk factors. The provisions take effect for plan years starting on or after January 1, 2024.
Key points
Zero Cost-Sharing: Insurance plans must cover diagnostic and supplemental breast exams without imposing deductibles, copayments, or coinsurance.
Covered Exams: This includes diagnostic mammography, breast MRI, and ultrasound used to evaluate abnormalities or screen high-risk individuals.
High Deductible Plans (HDHPs): HDHPs can cover these exams without a deductible while maintaining eligibility for Health Savings Accounts (HSAs).
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Additional Information
Access to Breast Cancer Diagnosis Act of 2023
Print number: S 2464
Sponsor: Sen. Shaheen, Jeanne [D-NH]
Process start date: 2023-07-25