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Bill

HB 1828

Health insurance; cost sharing for breast examinations.

2025 Regular Session Introduced by Bonita Anthony and 42 co-sponsors

Virginia eliminates health insurance cost-sharing for breast examinations and mammograms, effective July 1, 2025, removing copays and deductibles to increase screening access.

Acts of Assembly Chapter text (CHAP0485)
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Bill Summary · HB 1828

Legislative bill overview

HB 1828 eliminates cost-sharing requirements (copayments, coinsurance, and deductibles) for breast examinations covered under Virginia health insurance plans. The bill applies to both mammograms and clinical breast exams performed by healthcare providers. It became effective July 1, 2025, following gubernatorial approval in March.

Why is this important

Removing financial barriers to breast examinations can increase screening rates, potentially enabling earlier detection of breast cancer when treatment is most effective. This aligns with federal preventive care standards but extends protections at the state level. For patients, eliminating these costs removes a financial obstacle to accessing recommended health screenings.

Potential points of contention

  • Insurance cost implications: Health insurers may argue that zero cost-sharing increases overall plan costs, which could be reflected in premium increases for all enrollees
  • Definition ambiguity: The bill's scope regarding what qualifies as a "breast examination" may create implementation questions for insurers and providers about coverage boundaries
  • Equity concerns: While removing cost barriers benefits all insured Virginians, it does nothing for uninsured or underinsured populations who face access barriers beyond financial cost-sharing

Compiled from official sources — confirm details with the bill’s official record.

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