The Access to Breast Cancer Diagnosis Act of 2025 requires health insurance plans—both group and individual coverage—to cover diagnostic and supplemental breast examinations without any out-of-pocket costs to patients, including no deductibles, copayments, or coinsurance. The bill defines diagnostic breast exams as medically necessary tests like mammograms, MRIs, or ultrasounds used to evaluate suspected breast abnormalities, and supplemental exams as screening tests for those at higher risk based on personal or family medical history. The law applies to most health insurance plans starting January 1, 2026, and allows insurers to require prior authorization for these tests while also preserving any state protections that are more generous than federal requirements. Plans that include health savings accounts will not lose their tax-advantaged status simply because they waive deductibles for these breast exams, ensuring that patients with high-deductible plans can still access these diagnostic services without cost barriers.
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