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SB 1436

Health insurance; cost sharing for breast examinations.

2025 Regular Session Introduced by Luther Cifers and 2 co-sponsors

Virginia eliminates patient cost-sharing for breast examinations under all health insurance plans effective July 1, 2025, to increase preventive screening access.

Acts of Assembly Chapter text (CHAP0496)
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Bill Summary · SB 1436

Legislative bill overview

SB 1436 eliminates cost-sharing requirements (copayments, coinsurance, and deductibles) for breast examinations covered under Virginia health insurance plans. The bill became effective July 1, 2025, and applies to all health insurance policies issued or renewed after that date.

Why is this important

Removing financial barriers to breast examinations increases accessibility to preventive cancer screening, particularly benefiting lower-income individuals who may delay or skip care due to out-of-pocket costs. Early detection of breast cancer significantly improves treatment outcomes and reduces overall healthcare costs.

Potential points of contention

  • Insurance premium impacts: Eliminating cost-sharing for a covered service may increase insurance premiums for all policyholders, potentially offsetting savings for those who don't use breast examinations
  • Definition ambiguity: The bill's scope depends on how "breast examinations" is defined—whether it includes only clinical exams, mammograms, ultrasounds, MRIs, and biopsies, and whether related services are covered
  • Compliance burden: Insurance companies and healthcare providers must implement new billing and claims processing procedures, with potential compliance costs passed to consumers

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

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