Michigan House Bill HB5205

Michigan 2025-2026 Regular Session

• Introduced: 11/4/25
• Refer: 11/4/25

Caption

Insurance: health insurers; coverage for examinations and medications related to breast cancer; provide for. Amends sec. 3406d of 1956 PA 218 (MCL 500.3406d).

Impact

The implementation of HB 5205 signifies a notable shift in healthcare regulation within Michigan, ensuring that breast cancer-related services are recognized under health insurance policies without subjecting them to the dollar limits, deductibles, or copayments typically applicable to other physical illnesses. This move is projected to improve access to critical diagnostic and treatment services for women, ultimately promoting early detection and intervention, which are pivotal in combatting breast cancer.

Summary

House Bill 5205 aims to amend the 1956 Michigan Insurance Code, specifically focused on enhancing health insurance coverage related to breast cancer services. This bill mandates that health insurers must provide coverage for essential diagnostic services, outpatient treatments, and rehabilitative services for breast cancer. It also specifies coverage requirements for breast cancer screening mammography based on the age of the individual, stipulating at least one examination over five years for women aged 35 to 39, and one examination each calendar year for those aged 40 and above.

Contention

Notably, some points of contention could arise surrounding the bill's financial implications for insurance providers and the healthcare system at large. Critics may express concerns regarding the increased burden on insurance companies to cover these extended services, which could potentially lead to increased premiums or alterations in coverage areas that are less profitable. Additionally, discussions may emerge about how best to effectively implement these mandates while maintaining the sustainability of health insurance offerings.