§2. No-cost coverage of annual screening mammography beginning at 30 years of age
This section requires Medicare, Medicaid, and group health plans and health insurance coverage to provide no-cost coverage (i.e., no deductibles, coinsurance, or other cost-sharing) for annual screening mammography for women over 29 years of age (i.e., age 30 and older), effective January 1, 2026.
**Medicare.** The section revises frequency limits under SSA §1834(c) to prohibit payment for screening mammography performed before age 30 and, for women age 30 and older, to limit payment to no more than once every 12 months (not within 11 months following the month of a prior screening); it also eliminates beneficiary cost-sharing for such services on or after January 1, 2026 (lowering the coverage age threshold from 40). (Screening mammography detects breast cancer in asymptomatic women.)
**Medicaid.** The section makes annual screening mammography for individuals over 29 a mandatory Medicaid benefit under specified coverage categories (e.g., mandatory and medically needy groups and benchmark/alternative plans) and prohibits any cost-sharing for it beginning January 1, 2026.
**Group health plans and health insurance.** The section amends PHSA §2713 to require such plans and coverage to provide annual screening mammography for women over 29 without cost-sharing, applicable to plan years beginning on or after January 1, 2026.