What types of health insurance policies must provide coverage for mammograms?
The law requires most, but not all, insured disability policies that provide coverage to women age 45 and over to provide periodic coverage for mammograms. This includes policies offered by health maintenance organizations (HMOs). What is a disability policy? A “disability policy” is any insured policy that provides surgical, medical, hospital, major medical, or other health service coverage but does not include: • Hospital indemnity policies. • Policies that provide ancillary coverage such as income continuation, loss of time, or accidental benefits. • Policies that provide coverage of certain specified diseases such as cancer. • Policies offered by limited service health organizations. • Medicare supplement, Medicare replacement, or long-term care policies. Are health plans self-funded by an employer required to provide coverage for mammograms? Plans that are self-funded by an employer and subject to the Federal Employee Retirement Income Security Act (ERISA) and plans that are self-
