ID| The Idaho Department of Insurance Bulletin No. 25-03 provides compliance guidance for insurers regarding House Bill 134 (2025), which mandates that all health benefit plans in Idaho cover annual supplemental breast cancer screenings for individuals at increased risk, effective January 1, 2026. The law requires insurers to update plan documents and notify consumers about the new benefit, which must be provided without patient cost-sharing for eligible individuals, while clarifying that cost-sharing may still apply to other breast imaging services or out-of-network providers. Insurers must file updated forms and consumer notices with the Department and ensure that all affected insureds are informed of the changes at least 30 days before the effective date.
Key Points:
- Mandatory annual supplemental breast screening coverage for high-risk individuals, with no patient cost-sharing, effective January 1, 2026.
- Insurers must update plan documents, submit form filings, and provide clear consumer notices explaining the new benefit and eligibility criteria.
- Cost-sharing may still apply to other breast imaging services or out-of-network care, and all notifications must be distributed to insureds at least 30 days before the change takes effect.