HEALTH – Adds to existing law to establish provisions regarding breast cancer screening.

At-risk Idahoans get fully covered breast screenings

Beginning January 1, 2026, covered Idaho health plans must pay all costs for one supplemental breast screening each year. This means no deductible, copay, or coinsurance for that screening. The requirement covers individual and group plans that pay medical or surgical expenses. It applies to plans offered by insurers, group hospital service corporations, managed care organizations, fraternal benefit societies, and exchanges. The screening must be medically needed and appropriate, with no breast abnormality seen or suspected. Covered tests include standard or abbreviated MRI, contrast-enhanced mammography, or doctor-recommended ultrasound when the other imaging cannot be done. You qualify if you are believed to face increased risk based on any of these: a history of atypical breast tissue changes; personal or family breast cancer history; genetic risk; or prior chest radiation treatment. A lifetime breast cancer risk above 20%, measured by tools using family history, also qualifies. Extremely dense breast tissue under American College of Radiology categories qualifies on its own. Heterogeneously dense breast tissue qualifies with any one of these added risks: a BRCA1 or BRCA2 mutation; a parent, sibling, or child with either mutation when you have not been genetically tested; chest radiation treatment from ages 10 to 30; or Li-Fraumeni, Cowden, or Bannayan-Riley-Ruvalcaba syndrome in you or a parent, sibling, or child. The law still allows plan deductibles, copays, and coinsurance for breast imaging beyond this annual minimum.