This bill requires health insurers, including the State Health Benefits Program (SHBP) and the School Employees' Health Benefits Program (SEHBP), to provide coverage for mammograms for women aged 35 and older, as well as for women under 35 who have specific risk factors for breast cancer. It amends existing laws to mandate one baseline mammogram for women at age 35, annual mammograms for those aged 35 and over, and additional mammograms for younger women with a family history of breast cancer or other risk factors as determined by their healthcare provider.

Additionally, the bill ensures coverage for diagnostic tests such as ultrasounds or MRIs if the initial mammogram reveals dense breast tissue or other abnormalities, requiring that these services be covered to the same extent as any other medical condition under the insurance contract. The legislation lowers the age requirement for baseline mammograms from 40 to 35 and mandates similar coverage under the School Employees Health Benefits Program. The bill is set to take effect immediately and will apply to all health benefits plans currently in effect or renewed after its enactment.

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