The Vermont Statutes Online
The Statutes below include the actions of the 2025 session of the General Assembly.
NOTE: The Vermont Statutes Online is an unofficial copy of the Vermont Statutes Annotated that is provided as a convenience.
Subchapter
011
:
PREVENTION AND TREATMENT OF CANCER
(Cite as: 8 V.S.A. § 4095b)
-
§ 4095b. Mammography and other breast imaging services
(a)(1) A health insurance plan shall provide coverage for screening mammography and for other
medically necessary breast imaging services upon recommendation of a health care professional
as needed to detect the presence of breast cancer and other abnormalities of the breast
or breast tissue. In addition, a health insurance plan shall provide coverage for
screening by ultrasound or another appropriate imaging service for a covered individual
for whom the results of a screening mammogram were inconclusive or who has dense breast
tissue, or both.
(2) Benefits provided shall cover the full cost of the mammography, ultrasound, and other
breast imaging services and shall not be subject to any co-payment, deductible, coinsurance,
or other cost-sharing requirement or additional charge, except to the extent that
such coverage would disqualify a high-deductible health plan from eligibility for
a health savings account pursuant to 26 U.S.C. § 223.
(b) This section shall apply only to procedures conducted by test facilities accredited
by the American College of Radiologists.
(c) As used in this section:
(1) “Mammography” means the x-ray examination of the breast using equipment dedicated
specifically for mammography, including the x-ray tube, filter, compression device,
and digital detector. The term includes breast tomosynthesis.
(2) “Other breast imaging services” means diagnostic mammography, ultrasound, and magnetic
resonance imaging services that enable health care professionals to detect the presence
or absence of breast cancer and other abnormalities affecting the breast or breast
tissue.
(3) “Screening” includes the mammography or ultrasound test procedure and a qualified
health care professional’s interpretation of the results of the procedure, including
additional views and interpretation as needed. (Recodified and amended 2025, No. 11, § 2, eff. September 1, 2025.)