H.R. 10100: Screen to Save Act

This bill would require no-cost coverage of annual screening mammograms starting at age 30 under Medicare, Medicaid, and most private health insurance plans.

What it changes

• Medicare: Beginning January 1, 2027, Medicare would cover annual screening mammograms for women over age 29 without cost sharing. That means no deductibles, copays, or coinsurance for the covered screening.
• Medicaid: The bill adds annual screening mammography for women over age 29 as a covered Medicaid service, effective January 1, 2027. It also adjusts federal Medicaid financing rules so the federal matching rate applies to this coverage.
• Private insurance: For group health plans and individual health insurance plans, the bill would require annual mammography screening for women over age 29 to be covered as a preventive service, beginning with plan years on or after January 1, 2027.

How the coverage would work

• For people 30 and older, the bill requires coverage of one screening mammogram every year.
• For people under 30, Medicare would not pay for screening mammograms under the new rule.
• The bill also updates Medicare payment rules so the program would generally pay the full allowed amount for these screenings, rather than requiring cost sharing from the patient.

Timing

• Medicare and Medicaid changes: apply to services provided on or after January 1, 2027.
• Private insurance changes: apply to plan years beginning on or after January 1, 2027.

What this means in plain language

The bill would make yearly breast cancer screening mammograms available earlier, starting at age 30, and would generally require those screenings to be covered fully by Medicare, Medicaid, and most private insurance plans. Patients would not have to pay out of pocket for the covered screening itself, as long as it is provided under the bill’s rules.

Relevant Companies

• None found