This bill amends New Jersey law to enhance health insurance coverage for mammograms, specifically lowering the age requirement for baseline mammogram examinations from 40 to 35 years. It mandates that women aged 35 and older receive annual mammograms and allows women under 35 with specific risk factors, such as a family history of breast cancer, to access mammograms as deemed medically necessary by their healthcare provider. The bill also requires coverage for additional diagnostic tests, like ultrasounds or MRIs, if the initial mammogram indicates dense breast tissue or other risk factors for breast cancer.

Moreover, the bill extends these coverage requirements to health benefits plans under the State Health Benefits Program (SHBP) and the School Employees' Health Benefits Program (SEHBP), ensuring that all relevant health plans provide the same level of mammogram coverage. The benefits must be provided to the same extent as for any other medical condition under the health benefits plan. The act is set to take effect immediately and will apply to all health benefits plans currently in effect or renewed after the effective date.

Statutes affected:
Introduced: 17:48-6, 17:48A-7, 17:48E-35.4, 17B:26-2.1, 17B:27-46.1, 26:2J-4.4, 17B:27A-7.10, 17B:27A-19.13, 52:14-17.29