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HB 5241

Relating to insurance coverage for breast cancer screening

2026 Regular Session Introduced by Sean Hornbuckle

HB 5241 mandates West Virginia insurers cover breast cancer screening without patient cost-sharing to improve early detection and reduce treatment expenses.

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Bill Summary · HB 5241

Legislative bill overview

HB 5241 requires health insurance plans in West Virginia to provide coverage for breast cancer screening procedures without cost-sharing requirements (copayments, coinsurance, or deductibles). The bill ensures that preventive breast cancer screenings, including mammograms and related diagnostic services, are accessible to insured individuals at no out-of-pocket expense.

Why is this important

Removing financial barriers to preventive screening can increase early detection rates, which significantly improves treatment outcomes and survival rates for breast cancer. The bill aligns with federal preventive care standards while potentially reducing overall healthcare costs through earlier intervention rather than treating advanced-stage cancers.

Potential points of contention

  • Insurance cost implications: Insurers may argue that eliminating cost-sharing increases premium costs for all policyholders, though proponents counter that preventive care reduces long-term expenses
  • Scope definition: Disputes may arise over which specific screening procedures qualify (age thresholds, frequency, supplemental imaging modalities like ultrasound or MRI)
  • Coverage gaps: The bill may not address coverage for uninsured West Virginians or those with limited insurance options, leaving vulnerable populations without guaranteed access

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

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