Coverage for Breast Cancer Screenings in 2026

Beginning in 2026, many health insurance plans expanded coverage for preventive breast cancer screenings, making it easier for women to get follow-up testing without unexpected out-of-pocket costs. These changes are tied to updated recommendations from the Health Resources and Services Administration (HRSA) Women’s Preventive Services Guidelines, recent IRS guidance, and new state-level mandates aimed at improving access to early breast cancer detection. We’ve covered updates to preventative care in the past at our blog post here, and we’ve outlined the gist of what you need to know going into your next mammogram below:

In the past, it wasn't uncommon for a routine screening mammogram to lead to additional imaging that was billed as diagnostic care, leaving patients with deductibles or copays. Updated federal guidelines and Illinois requirements now recognize that these follow-up services are often part of the screening process itself. Now, because of expanded coverage, medically necessary follow-up imaging after an abnormal screening mammogram is covered as preventive care. 

These updates encourage folks to complete any recommended follow-up testing they may have avoided for financial reasons, increasing the chance of early detection. Coverage and cost can still vary depending on your insurance carrier and plan, and the in-network status of your provider, however. It's always a good idea to verify the specific benefits of your plan before scheduling an appointment. If you have questions about how your plan covers mammograms, breast ultrasounds, MRIs, or other preventive screenings, reach out! Our team is happy to help you understand your coverage and options to ensure you get the care you need.