Bill > SB518

This bill requires health insurance policies in West Virginia to cover diagnostic and supplemental breast examinations without any out-of-pocket costs for the patient, meaning individuals will not have to pay deductibles, copayments, or coinsurance for these services. Diagnostic breast examinations are defined as medically necessary and appropriate tests, including MRIs, ultrasounds, or diagnostic mammograms, used to investigate a potential abnormality or an abnormality detected by other means. Supplemental breast examinations are also medically necessary and appropriate tests, including MRIs and ultrasounds, used for screening when there's no known abnormality but the individual has risk factors like family history. The bill clarifies that this provision applies to various types of health benefit policies and insurers, with specific effective dates for new and renewed coverage, and allows for existing utilization review processes to continue. It also includes an exception for high-deductible health plans that qualify for Health Savings Accounts, ensuring that cost-sharing requirements for these plans only apply after the minimum deductible is met, unless the service is considered preventive care under federal law.

Budget and Finance, Health and Social Services

http://www.wvlegislature.gov/Bill_Status/Bills_history.cfm?input=518&year=2026&sessiontype=RS&btype=bill