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Expanded Breast Cancer Screening Coverage Required for Health Plans in 2026

Written by RMC Group | Jul 7, 2025 12:45:00 PM

New HRSA guidelines call for first-dollar coverage of additional imaging and patient navigation services.

Beginning with plan years starting after December 30, 2025, group health plans and health insurance issuers will be required to expand their preventive care coverage for breast cancer screening under the Affordable Care Act (ACA). These updates are part of a growing national emphasis on early detection and comprehensive patient support—both vital components of improving health outcomes for women.

In our previous blog post on preventative care, we discussed how first-dollar coverage of screenings and immunizations helps employers support healthier, more engaged workforces. Now, with the latest update from the Health Resources and Services Administration (HRSA), plan sponsors must prepare for even more robust requirements aimed at closing gaps in early cancer detection and care.

 

What Is First-Dollar Coverage?

First-dollar coverage means that the health plan pays for eligible services from the very first dollar, without deductibles, copayments, or coinsurance. This differs from other types of services under most health plans where the insured must first meet an out-of-pocket threshold before benefits apply.

Key features of first-dollar coverage:

  • No upfront costs: Patients do not pay anything out-of-pocket for covered services, like preventive screenings.
  • Immediate coverage: Insurers start covering eligible services right away.

 

Example:

A woman goes in for her routine, annual screening mammogram at an in-network facility. Even though her health insurance plan has a $2,000 deductible, she pays nothing out of pocket for the mammogram because it is considered a preventive service. The plan covers the full cost of the screening from the first dollar, meaning no deductible, copay, or coinsurance applies. Starting in 2026, if additional imaging such as an ultrasound or MRI is needed to complete a screening, those services must also be covered in full.

 

What’s Changing in 2026?

Under the ACA, non-grandfathered group health plans must cover recommended preventive services without cost sharing when delivered by in-network providers. These include services rated A or B by the U.S. Preventive Services Task Force and guidelines supported by HRSA.

Effective for plan years beginning on or after December 30, 2025, the following changes apply:

1. Expanded Breast Cancer Screening

Health plans must now cover not only the initial mammogram but also any additional imaging or pathology evaluations needed to complete the screening process. This may include:

  • Follow-up mammography
  • Ultrasound
  • MRI
  • Pathology review

This is especially critical when initial screening results are inconclusive or raise concerns, ensuring that individuals can pursue further evaluation without delay or financial burden.

2. Patient Navigation Services

Plans must also cover individualized patient navigation services for breast and cervical cancer screenings, including:

  • Person-centered care coordination
  • Access to timely follow-up care
  • Referrals for support services (translation, transportation, etc.)
  • Education about the screening and treatment process

These services are designed to reduce disparities in care and improve health outcomes by supporting patients through complex care systems.

 

What Employers Need to Do

  • Review your plan documents to determine whether these services are currently included.
  • Work with your benefits broker or TPA to ensure your plan complies with the new 2026 requirements.
  • Update your Summary Plan Description (SPD) or issue a Summary of Material Modifications (SMM) to inform participants of coverage changes.

The upcoming changes to breast cancer screening requirements reinforce the importance of first-dollar coverage in preventive care. By eliminating cost barriers for additional imaging and offering patient navigation support, these updates will help close care gaps and lead to earlier diagnoses and better outcomes.

Not sure how these changes impact your current benefits? RMC Group is here to help you build a smarter, more supportive plan—one that puts preventive care and your people first.

Click here to schedule a meeting today with out Health Insurance Team.