Wisconsin Expands Insurance Coverage for Diagnostic and Supplemental Breast Screening
By Jennifer Footit-Tank, BSN, RN, CCP, quality care coordinator at Network Health
3/25/2026
Governor Evers recently signed Gail’s Law (2025 Wisconsin Act 103) into law. Beginning January 1, 2027, all insurance companies, including BadgerCare, will be required to cover the first medically necessary supplemental breast screening or any diagnostic breast examinations for women at increased risk for breast cancer. With this change, Wisconsin joins 31 other states with similar legislation.
Currently, Wisconsin law requires insurance companies to cover:
- Two screening mammograms for women ages 45–49 with certain risk factors.
- Annual mammograms beginning at age 50, regardless of symptoms.
Gail’s law provides expanded access to breast cancer screening.
What Does This Mean?
A screening mammogram is an annual or biannual test used to detect abnormalities in breast tissue. These screenings typically have no cost to the patient.
A diagnostic breast examination is ordered when a screening detects or is suspected to detect an abnormality. This may include:
- Ultrasound
- Breast tomosynthesis
- Contrast-enhanced mammography
- Diagnostic mammography
- MRI
These tests often came with copayments or deductibles, which led many women to delay or decline additional imaging. For some families, the cost created a painful choice between medical care and household needs. Gail’s Law eliminates these out-of-pocket costs, ensuring women do not have to postpone essential follow-up testing.
Supplemental Breast Screening
Supplemental screening uses many of the same imaging methods as diagnostic testing but is recommended for women who have no known abnormality yet have increased risk due to personal or family history. When eligibility criteria are met, Gail’s Law requires insurers to cover these screenings at no cost.
Dense Breast Tissue
Some women are found to have heterogeneously or extremely dense breasts on previous mammograms — a completely normal finding that affects nearly 40 percent of women. Traditional mammography is less effective for these women because dense tissue and cancer both appear white on the image, making abnormalities harder to detect. They benefit more from imaging techniques used in diagnostic screenings. Gail’s Law removes the cost barriers that once applied to these tests.
Why This Matters
The Wisconsin Breast Cancer Coalition estimates that roughly 6,000 Wisconsin women—or one in eight—were diagnosed with breast cancer last year. Gail’s Law is a significant step forward, strengthening early detection and expanding access to potentially lifesaving screenings.
If you have questions about your coverage, contact your health plan provider. If you are uninsured, the Wisconsin Well Woman Program (WWWP) may help you access free breast and cervical cancer screenings.
