(1) As used in this section:

Ask an insurance law question, get an answer ASAP!
Click here to chat with a lawyer about your rights.

(a) ‘Diagnostic breast examination’ means an examination used to evaluate an abnormality of the breast that is detected or suspected from a screening examination for breast cancer or by any other means of examination using:

(A) Diagnostic mammography;

(B) Breast magnetic resonance imaging; or

(C) Breast ultrasound.

(b) ‘Supplemental breast examination’ means an examination of the breast, such as breast magnetic resonance imaging or breast ultrasound, that is:

(A) Used to screen for breast cancer when there is no abnormality seen or suspected; and

(B) Based on personal or family medical history or other factors that increase an individual’s risk of breast cancer.

(2) Except as provided in ORS § 742.008, a carrier offering a group health benefit plan or an individual health benefit plan in this state that reimburses the cost of supplemental or diagnostic breast examinations may not impose on the coverage of a medically necessary supplemental or diagnostic breast examination:

(a) A deductible;

(b) Coinsurance;

(c) A copayment; or

(d) Other out-of-pocket expenses. [2023 c.468 § 2]

See 743A.001.

743A.101 was added to and made a part of the Insurance Code by legislative action but was not added to ORS Chapter 743A or any series therein. See Preface to Oregon Revised Statutes for further explanation.