Act 52 of 2025: No-cost Diagnostic Breast Imaging
Act 52 of 2025 (Senate Bill 88), introduced by PA Senator Frank Farry and PA Senate President Pro Tempore Kim Ward, eliminates all out-of-pocket costs for diagnostic mammograms, breast MRI and ultrasounds for individuals insured under PA law. The law, which will be fully implemented by January 2028, expands on the comprehensive coverage of Act 1 of 2023.
When in full effect, the law provides coverage for the following at no cost for those with state-regulated insurance:
- Diagnostic mammograms
- Diagnostic breast MRI
- Diagnostic breast ultrasound
Act 52 applies to state-regulated insurance. This includes state-regulated plans purchased through the Pennie marketplace or employer-provided insurance. To find out if your employer-covered plan is state-regulated, contact your human resources or benefits administrator. It does not impact self-insured plans or federally regulated plans including ERISA, Medicare or Medicaid.
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If you’ve reached out to your insurer and benefits administrator and still have questions about no-cost breast imaging coverage under Act 1 of 2023 or Act 52 of 2025, please contact the Pennsylvania Insurance Department or the PA Breast Cancer Coalition.
