BOISE, ID – Months before a new Idaho law will require health insurance companies to expand breast cancer screening coverage, the Idaho Department of Insurance is guiding insurers on how to prepare.
The Idaho Legislature widely approved the new law through House Bill 134 this year. But the law doesn’t take effect until Jan. 1, 2026.
The new law will require health insurance companies to cover supplemental breast cancer screening when abnormalities aren’t found or suspected in the breast of people who are at high risk.
“Early detection saves lives, and I’m thrilled to have helped pass this impactful legislation that will make life-saving care more affordable and accessible for so many Idaho women at high risk for breast cancer,” Rep. Brooke Green, a Boise Democrat who sponsored the bipartisan-backed legislation while she battles breast cancer, said in a written statement.
Days after her first breast cancer diagnosis, Green’s radiologist brought the issue to her attention, she previously told the Sun. In a show of solidarity, several Idaho lawmakers shaved their heads in late March, as Green prepared to start chemotherapy.
How the bill works: No extra patient cost for an extra screening in-network
Under the bill, people will be considered at high risk for breast cancer due to personal or family history, genetic predisposition or other factors. Supplemental breast cancer screening required to be covered by the bill includes magnetic resonance imaging, or an MRI.
According to a news release last week by the Idaho Department of Insurance, the new law requires health insurance plans cover “all costs associated with one supplemental breast cancer screening every year” for people covered by their health insurance plans who have a high risk of breast cancer.
Here’s how that will work:
- That screening “must be covered with no patient cost-sharing,” which includes deductibles, copayments or coinsurance, if it is provided by in-network health care providers, the Idaho Department of Insurance says.
- Additional costs can be charged for services from out-of-network providers.
- For other breast imaging services that go beyond the new law’s minimum service requirements, such as diagnostic imaging or supplemental screenings conducted more than once a year, the health insurance plan’s patient cost-sharing rules can apply, the insurance department says.
Idaho health insurance companies must update their plan documents and notify members about the new benefits, according to new guidance to insurers from the Idaho Department of Insurance.
“Consumers should contact their insurer with any questions, or contact our department if they experience coverage issues,” Idaho Department of Insurance Market Oversight Bureau Chief Shannon Hohl said in a written statement. “Our consumer affairs team is available to help with insurance questions and concerns.”
In a written statement, Idaho Department of Insurance Director Dean Cameron thanked the Legislature and several lawmakers for supporting the bill, saying it will “help Idahoans access the critical preventive services they need.”
This story first appeared on Idaho Capital Sun.
