                                 CODE OF VIRGINIA

COVERAGE FOR PROSTATE CANCER SCREENING (§ 38.2-3418.7)

A. Notwithstanding the provisions of &#xA7; 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, &#8220;prostate cancer screening&#8221;
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.
&#xA7; 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&#8217;
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: 1998, cc. 709, 858; 2025, cc. 237, 246.