Certain Indiana health plans would cover breast exams without copays

State employee health plans would cover extra breast screening and would not charge patients deductibles or copays for covered breast cancer tests. This covers women in a state employee health plan, including a state-contracted health plan. Extra screening must be medically necessary and appropriate, with no abnormality found, and based on personal or family history or other factors that may raise breast cancer risk. If enacted, these rules would take effect July 1, 2026.

Indiana health insurers would cover exams for suspected breast problems and extra screening tied to cancer risk without charging patients deductibles or copays. This applies to accident and sickness insurance policies issued in Indiana. These exams must be medically necessary and appropriate. Extra screening applies when no abnormality is found and personal or family history or other factors may raise breast cancer risk. For policies outside work, insurers would have to offer this coverage. If enacted, these rules would take effect July 1, 2026.

Indiana health maintenance organizations would cover breast exams for suspected problems and extra screening tied to cancer risk in covered group plans. This covers Indiana group contracts that provide basic health care through a health maintenance organization. Extra screening must be medically necessary and appropriate. It applies when no abnormality is found and personal or family history or other factors may raise breast cancer risk. Covered exams would have no patient cost sharing; plans outside work would have to offer this coverage. If enacted, these rules would take effect July 1, 2026.