Fla. Stat. 627.6613
Coverage for mammograms


(1)

A group, blanket, or franchise accident or health insurance policy issued, amended, delivered, or renewed in this state must provide coverage for at least the following:A baseline mammogram for any woman who is 35 years of age or older, but younger than 40 years of age.A mammogram every 2 years for any woman who is 40 years of age or older, but younger than 50 years of age, or more frequently based on the patient’s physician’s recommendation.A mammogram every year for any woman who is 50 years of age or older.One or more mammograms a year, based upon a physician’s recommendation, for any woman who is at risk for breast cancer because of a personal or family history of breast cancer, because of having a history of biopsy-proven benign breast disease, because of having a mother, sister, or daughter who has or has had breast cancer, or because a woman has not given birth before the age of 30.

(a)

A baseline mammogram for any woman who is 35 years of age or older, but younger than 40 years of age.

(b)

A mammogram every 2 years for any woman who is 40 years of age or older, but younger than 50 years of age, or more frequently based on the patient’s physician’s recommendation.

(c)

A mammogram every year for any woman who is 50 years of age or older.

(d)

One or more mammograms a year, based upon a physician’s recommendation, for any woman who is at risk for breast cancer because of a personal or family history of breast cancer, because of having a history of biopsy-proven benign breast disease, because of having a mother, sister, or daughter who has or has had breast cancer, or because a woman has not given birth before the age of 30.

(2)

Except as provided in paragraph (1)(b), for mammograms done more frequently than every 2 years for women 40 years of age or older but younger than 50 years of age, the coverage required by subsection (1) applies, with or without a physician prescription, if the insured obtains a mammogram in an office, facility, or health testing service that uses radiological equipment registered with the Department of Health for breast cancer screening. The coverage is subject to the deductible and coinsurance provisions applicable to outpatient visits, and is also subject to all other terms and conditions applicable to other benefits. This section does not affect any requirements or prohibitions relating to who may perform, analyze, or interpret a mammogram or the persons to whom the results of a mammogram may be furnished or released.

(3)

Every insurer referred to in subsection (1) shall make available to the policyholder as part of the application, for an appropriate additional premium, the coverage required in this section without such coverage being subject to the deductible or coinsurance provisions of the policy.

Source: Section 627.6613 — Coverage for mammograms, https://www.­flsenate.­gov/Laws/Statutes/2024/0627.­6613 (accessed Aug. 7, 2025).

627.651
Group contracts and plans of self-insurance must meet group requirements
627.652
Group health insurance
627.653
Employee groups
627.654
Labor union, association, and small employer health alliance groups
627.655
Debtor groups
627.656
Additional groups
627.657
Provisions of group health insurance policies
627.658
Use of dividends, refunds, rate reductions, commissions, service fees
627.659
Blanket health insurance
627.660
Conditions and provisions of blanket health insurance policies
627.661
School accident insurance claims
627.662
Other provisions applicable
627.663
Franchise health insurance
627.664
Assignment of incidents of ownership in group, blanket, or franchise health policies
627.666
Liability of succeeding insurer on replacement of group, blanket, or franchise health insurance policy
627.667
Extension of benefits
627.668
Optional coverage for mental and nervous disorders required
627.669
Optional coverage required for substance abuse impaired persons
627.6512
Exemption of certain group health insurance policies
627.6513
Scope
627.6515
Out-of-state groups
627.6516
Trustee groups
627.6525
Short-term health insurance
627.6551
Teacher and student groups
627.6561
Preexisting conditions
627.6562
Dependent coverage
627.6563
Full-time employment defined
627.6571
Guaranteed renewability of coverage
627.6572
Pharmacy benefit manager contracts
627.6574
Maternity care
627.6575
Coverage for newborn children
627.6577
Dental care
627.6578
Coverage for natural-born, adopted, and foster children
627.6579
Coverage for child health supervision services
627.6612
Coverage for surgical procedures and devices incident to mastectomy
627.6613
Coverage for mammograms
627.6615
Children with disabilities
627.6616
Coverage for ambulatory surgical center service
627.6617
Coverage for home health care services
627.6618
Payment of acupuncture benefits to certified acupuncturists
627.6619
Massage
627.6621
Advanced practice registered nurse services
627.6645
Notification of cancellation, expiration, nonrenewal, or change in rates
627.6646
Cancellation or nonrenewal prohibited
627.6648
Shared savings incentive program
627.6651
Replacement or termination of group, blanket, or franchise health policy or contract
627.6675
Conversion on termination of eligibility
627.6686
Coverage for individuals with autism spectrum disorder required
627.6691
Coverage for osteoporosis screening, diagnosis, treatment, and management
627.6692
Florida Health Insurance Coverage Continuation Act
627.6698
Attorney’s fees
627.6699
Employee Health Care Access Act
627.65612
Limit on preexisting conditions
627.65615
Special enrollment periods
627.65625
Prohibiting discrimination against individual participants and beneficiaries based on health status
627.65626
Insurance rebates for healthy lifestyles
627.65735
Nondiscrimination of coverage for surgical procedures
627.65736
Coverage for organ transplants
627.65745
Diabetes treatment services
627.65755
Dental procedures
627.66121
Coverage for length of stay and outpatient postsurgical care
627.66122
Requirements with respect to breast cancer and routine followup care
627.66911
Required coverage for cleft lip and cleft palate
627.66996
Restrictions on use of state and federal funds for state exchanges
627.66997
Stop-loss insurance

Current through Fall 2025

§ 627.6613. Coverage for mammograms's source at flsenate​.gov