Find It Early Act

Elimination of Financial Barriers for High-Risk Individuals: Individuals at increased risk of breast cancer or those with heterogeneously or extremely dense breast tissue can access screening and diagnostic imaging, such as 2D or 3D mammograms, ultrasounds, or breast MRI, with no cost-sharing and no limitation on frequency. This applies to group health plans (Section 2, a, 1, E, i), Medicare (Section 2, b, 1, ii), Medicaid (Section 2, c, 1, G, i), TRICARE (Section 2, d, 1, B, i), and certain veterans (Section 2, e, 1, A, 2, A).

Expanded Access Based on Clinical Determination: People who are not explicitly categorized by risk or tissue density but are determined by a healthcare provider to require screening due to factors like age, race, ethnicity, or personal/family medical history can receive screening and diagnostic imaging without cost-sharing. This applies to group health plans (Section 2, a, 1, E, ii), Medicare (Section 2, b, 1, ii), Medicaid (Section 2, c, 1, G, ii), TRICARE (Section 2, d, 1, B, ii), and certain veterans (Section 2, e, 1, A, 2, B).

Protection for Medicare Advantage Members: Coverage for these specific screenings and diagnostic imaging will be included in Medicare Advantage plans (Section 2, b, 2).

Standardization of Coverage for Medicaid: States are prohibited from providing benchmark coverage that excludes these specific breast cancer screenings and diagnostic imaging for eligible individuals (Section 2, c, 3).