Maryland Insurance Section 15-814

Article - Insurance

§ 15-814.

      (a)      In this section, "mammogram" means an x-ray examination of the breast using dedicated equipment, including an x-ray tube, filter, compression device, screens, films, and cassettes, specifically for mammography that delivers an average radiation exposure of less than one rad mid-breast with two views for each breast.

      (b)      This section applies to each individual hospital or major medical insurance policy, group or blanket health insurance policy, and nonprofit health service plan that is delivered or issued for delivery in the State and is written on an expense-incurred basis.

      (c)      A policy or plan subject to this section shall provide coverage for:

            (1)      a baseline mammogram for women who are 35 to 39 years old;

            (2)      a mammogram every 2 years, or more frequently if recommended by a physician, for women who are 40 to 49 years old; and

            (3)      an annual mammogram for women who are at least 50 years old.

      (d)      A policy or plan subject to this section is not required to cover screening mammograms used to identify breast cancer in asymptomatic women that are provided by a facility that is not accredited by the American College of Radiology or certified or licensed under a program established by the State.

      (e)      (1)      A policy or plan subject to this section may not impose a deductible on the coverage required under this section.

            (2)      Each health insurance policy and certificate shall contain a notice of the prohibition established by paragraph (1) of this subsection in a form approved by the Commissioner.



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