§ 38.2-3418.7 Coverage for prostate cancer screening
A. Notwithstanding the provisions of § 38.2-3419, each insurer proposing to issue individual or group accident and sickness insurance policies providing hospital, medical and surgical, or major medical coverage on an expense-incurred basis; each corporation providing individual or group accident and sickness subscription contracts; and each health maintenance organization providing a health care plan for health care services shall provide coverage to (i) persons age 50 and over and (ii) persons age 40 and over who are at high risk for prostate cancer, according to the most recent published guidelines of the American Cancer Society, for prostate cancer screening under any such policy, contract, or plan delivered, issued for delivery, or renewed in the Commonwealth on and after July 1, 1998.
B. For the purpose of this section, “prostate cancer screening” includes one prostate-specific antigen test in a 12-month period and digital rectal examinations.
C. No insurer, corporation, or health maintenance organization shall impose on any person receiving benefits pursuant to this section any deductible, coinsurance, copayment, or other cost-sharing requirement, except to the extent that coverage without cost-sharing would disqualify a high-deductible health benefit plan from eligibility for a health savings account pursuant to 26 U.S.C. § 223.
D. The provisions of this section shall not apply to (i) short-term travel, accident only, limited or specified disease policies other than cancer policies, (ii) short-term nonrenewable policies of not more than six months’ duration, or (iii) policies or contracts designed for issuance to persons eligible for coverage under Title XVIII of the Social Security Act, known as Medicare, or any other similar coverage under state or federal governmental plans.
History
This law was first created in 1998. The record of its establishment is cataloged in chapters 709 and 858 of that year’s edition of “Acts of Assembly,” the annual state publication listing all changes made to the Code of Virginia in that year. It has been modified 1 time. Those modifications are cataloged by “The Acts of Assembly,” a state publication, by year and chapter. Those modifications that can be read on the General Assembly’s website will be linked accordingly. That modification is as follows: in 2025, chapters 237 and 246.
1998, cc. 709, 858; 2025, cc. 237, 246.