Loading…
S. 1500119th CongressIn committeeLatest action Apr 28, 2025Decoded by AI · checked against the record
Official title: Access to Breast Cancer Diagnosis Act of 2025
Introduced:
Read the official bill on Congress.govThe plain-language version leads. The official text is always the reference.
Starting in 2026, most health plans must cover follow-up and supplemental breast exams with no copays, deductibles, or coinsurance.
45-second read · 4 questions answered below
This bill would require health insurance plans to cover two types of breast exams at no cost to the patient: diagnostic exams ordered after a suspicious finding, and supplemental exams ordered for people at higher risk due to personal or family history. Both types must be considered medically necessary and appropriate under National Comprehensive Cancer Network Guidelines. Insurers could still require prior authorization before approving these exams.
This rule would apply to most health insurance plans, including employer-sponsored group plans, individual plans, grandfathered health plans, and high-deductible health plans paired with Health Savings Accounts. It would affect patients whose plans cover plan years starting on or after January 1, 2026.
Without this requirement, patients in qualifying plans may currently face out-of-pocket costs for these types of breast exams. If the bill becomes law, those costs would no longer be charged to the patient for covered exams.
AI-drafted summary. Verify it against the official text before you act on it. Read the official bill on Congress.gov
Right now: a Senate committee is reviewing it. If the House changes it, it goes back to the Senate before reaching the President.
Latest action: — Read twice and referred to the Committee on Health, Education, Labor, and Pensions.