In compliance with PA Act 1 of 2023, Independence Blue Cross will cover supplemental breast and ovarian cancer screenings for high-risk women at no cost.  

Per the mandate, “supplemental breast screening" means a medically necessary and clinically appropriate examination of the breast using either standard or abbreviated magnetic resonance imaging or, if such imaging is not possible, ultrasound if recommended by the treating physician to screen for breast cancer when there is no abnormality seen or suspected in the breast.  

In addition, the mandate requires coverage for BRCA-related genetic counseling and genetic testing provided by an individual licensed, certified or otherwise regulated to provide genetic counseling and genetic testing under Pennsylvania laws. 

Starting January 1, 2024, we began modifying our plans to remove cost-sharing for an annual supplemental breast cancer screening, such as a breast MRI or ultrasound, and for BRCA1 and BRCA2-related genetic testing and counseling for individuals at high risk of breast or ovarian cancer. This change will help increase access to these services and potentially improve breast and ovarian cancer detection and outcomes for Pennsylvania residents. 

Updates and timelines vary by plan, and some exceptions apply. While coverage for some plans became effective January 1, 2024, other plans will become effective January 1, 2025. Please use the Eligibility & Benefits transaction in PEAR Practice Management to confirm member benefits. 

Referrals are not required for these services. 

If you have any questions, please contact Provider Customer Service at 1-800-ASK-BLUE (1-800-275-2583).