"Michelle's Law"; requires health benefit plans to cover mammogram for an individual if recommended by health care provider.

S 855, "Michelle's Law," requires all health insurance plans in New Jersey to cover mammograms when recommended by a healthcare provider. It mandates coverage for a baseline mammogram at age 40, annual mammograms for women 40 and older, and mammograms for women under 40 with specific risk factors (like family history or dense breast tissue) as determined by their doctor. The law also requires coverage for additional tests like ultrasounds or MRIs after a mammogram if medically necessary due to breast density, abnormal results, or other risk factors. Insurance companies may review the medical necessity of these additional tests but cannot deny coverage for recommended screenings. This applies to all group and individual health insurance plans sold in New Jersey.