No-cost Breast Imaging in Pennsylvania
Pennsylvania has taken important steps to expand access to lifesaving breast imaging through two key laws that apply to state-regulated insurance plans. opens in a new windowAct 1 of 2023 ensures that supplemental breast cancer screening MRI and ultrasound for individuals at higher risk are covered with no out-of-pocket costs. A second law, opens in a new windowAct 52 of 2025, eliminates all out-of-pocket costs for diagnostic breast imaging, including mammograms, MRI and ultrasounds needed to evaluate an abnormal finding. Act 52 is currently beginning the implementation process, with full implementation by January 2028. Together, these laws are designed to remove financial barriers, support early detection, and help Pennsylvanians access the care they need without delay.
*Mammograms for women diagnosed with breast cancer may be considered diagnostic for years following diagnosis.
**Self-insured and federally regulated insurance plans, including ERISA and Medicare, are not subject to Pennsylvania state law. Many of these plans cover diagnostic breast imaging, but patients may still be responsible for copays and deductibles. Check your specific policy or ask your benefits administrator for coverage information.
Uninsured or Underinsured?
If you do not have insurance or are considered underinsured (high-deductible plan, etc.), you may qualify for a no-cost mammogram including follow-up imaging through the opens in a new windowPA Department of Health’s Breast and Cervical Cancer Early Detection Program (PA-BCCEDP). To learn more, contact our Director of Patient Advocacy by opens in a new windowclicking here.
We’re here to help!
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.
