CO| The Colorado Division of Insurance has issued Bulletin B-4.146 regarding coverage of preventive breast cancer screening studies. It provides guidance to insurers offering health benefit plans in Colorado, excluding grandfathered plans, on the requirement to cover preventive breast cancer screening studies without cost-sharing. The bulletin emphasizes that annual preventive breast cancer screening using appropriate imaging modalities, as determined by the provider, must be covered without cost-sharing. Additionally, it clarifies that further diagnostic or supplemental imaging for high-risk individuals or those with high breast density should also be covered without cost-sharing when recommended by the provider and within appropriate use guidelines.
Key points:
- The policy applies to all health benefit plans in Colorado, including student health plans, but excludes grandfathered plans.
- Insurers must cover annual preventive breast cancer screening and additional imaging (diagnostic or supplemental) without cost-sharing when recommended by the provider.
- Carriers are required to clearly state this coverage in plan documents, such as Evidence of Coverage or Certificate of Coverage.