This bill amends New Jersey law to enhance coverage for mammograms by lowering the age requirement for women to receive a baseline mammogram from 40 to 35 years. It mandates that insurers provide coverage for one baseline mammogram for women aged 35 and older and requires annual mammogram examinations for women aged 35 and over. Additionally, for women under 35 who have a family history of breast cancer or other risk factors, the bill allows for mammogram examinations at intervals deemed medically necessary by their healthcare provider.

Furthermore, the bill stipulates that insurers must cover additional testing, such as ultrasound evaluations or magnetic resonance imaging, if the initial mammogram indicates dense breast tissue or other risk factors for breast cancer. This coverage is subject to utilization review by insurance providers to assess medical necessity. The provisions apply to various health insurance contracts, ensuring that these benefits are provided to the same extent as for any other medical condition under the policy. The act is set to take effect immediately and will apply to all health benefits plans issued or renewed in the state 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, 17B:27A-7.10, 17B:27A-19.13, 26:2J-4.4, 52:14-17.29