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8 a. “Cost sharing” means the total of any deductible, copayment, or coinsurance
9amounts imposed on a person covered under a policy or plan.
10 b. “Self-insured health plan” has the meaning given in s. 632.85 (1) (c).
11 2. Every disability insurance policy and self-insured health plan that covers
12insulin and imposes cost sharing on prescription drugs may not impose cost sharing
13on insulin in an amount that exceeds $50 for a one-month supply of insulin.
14 3. Nothing in this paragraph prohibits a disability insurance policy or
15self-insured health plan from imposing cost sharing on insulin in an amount less
16than the amount specified under subd. 2. Nothing in this paragraph requires a
17disability insurance policy or self-insured health plan to impose any cost sharing on
18insulin.
19Section 2975. 632.895 (8) (d) of the statutes is amended to read:
20 632.895 (8) (d) Coverage is required under this subsection despite whether the
21woman shows any symptoms of breast cancer. Except as provided in pars. (b), (c), and
22(e), coverage under this subsection may only be subject to exclusions and limitations,
23including deductibles, copayments and restrictions on excessive charges, that are
24applied to other radiological examinations covered under the disability insurance

1policy. Coverage under this subsection may not be subject to any deductibles,
2copayments, or coinsurance.
3Section 2976. 632.895 (13m) of the statutes is created to read:
4 632.895 (13m) Preventive services. (a) In this section, “self-insured health
5plan” has the meaning given in s. 632.85 (1) (c).
6 (b) Every disability insurance policy, except any disability insurance policy that
7is described in s. 632.745 (11) (b) 1. to 12., and every self-insured health plan shall
8provide coverage for all of the following preventive services:
9 1. Mammography in accordance with sub. (8).
10 2. Genetic breast cancer screening and counseling and preventive medication
11for adult women at high risk for breast cancer.
12 3. Papanicolaou test for cancer screening for women 21 years of age or older
13with an intact cervix.
14 4. Human papillomavirus testing for women who have attained the age of 30
15years but have not attained the age of 66 years.
16 5. Colorectal cancer screening in accordance with sub. (16m).
17 6. Annual tomography for lung cancer screening for adults who have attained
18the age of 55 years but have not attained the age of 80 years and who have health
19histories demonstrating a risk for lung cancer.
20 7. Skin cancer screening for individuals who have attained the age of 10 years
21but have not attained the age of 22 years.
22 8. Counseling for skin cancer prevention for adults who have attained the age
23of 18 years but have not attained the age of 25 years.
24 9. Abdominal aortic aneurysm screening for men who have attained the age of
2565 years but have not attained the age of 75 years and who have ever smoked.

110. Hypertension screening for adults and blood pressure testing for adults, for
2children under the age of 3 years who are at high risk for hypertension, and for
3children 3 years of age or older.
4 11. Lipid disorder screening for minors 2 years of age or older, adults 20 years
5of age or older at high risk for lipid disorders, and all men 35 years of age or older.
6 12. Aspirin therapy for cardiovascular health for adults who have attained the
7age of 55 years but have not attained the age of 80 years and for men who have
8attained the age of 45 years but have not attained the age of 55 years.
9 13. Behavioral counseling for cardiovascular health for adults who are
10overweight or obese and who have risk factors for cardiovascular disease.
11 14. Type II diabetes screening for adults with elevated blood pressure.
12 15. Depression screening for minors 11 years of age or older and for adults when
13follow-up supports are available.
14 16. Hepatitis B screening for minors at high risk for infection and adults at high
15risk for infection.
16 17. Hepatitis C screening for adults at high risk for infection and onetime
17hepatitis C screening for adults born in any year from 1945 to 1965.
18 18. Obesity screening and management for all minors and adults with a body
19mass index indicating obesity, counseling and behavioral interventions for obese
20minors who are 6 years of age or older, and referral for intervention for obesity for
21adults with a body mass index of 30 kilograms per square meter or higher.
22 19. Osteoporosis screening for all women 65 years of age or older and for women
23at high risk for osteoporosis under the age of 65 years.
24 20. Immunizations in accordance with sub. (14).

121. Anemia screening for individuals 6 months of age or older and iron
2supplements for individuals at high risk for anemia and who have attained the age
3of 6 months but have not attained the age of 12 months.
4 22. Fluoride varnish for prevention of tooth decay for minors at the age of
5eruption of their primary teeth.
6 23. Fluoride supplements for prevention of tooth decay for minors 6 months of
7age or older who do not have fluoride in their water source.
8 24. Gonorrhea prophylaxis treatment for newborns.
9 25. Health history and physical exams for prenatal visits and for minors.
10 26. Length and weight measurements for newborns and height and weight
11measurements for minors.
12 27. Head circumference and weight-for-length measurements for newborns
13and minors who have not attained the age of 3 years.
14 28. Body mass index for minors 2 years of age or older.
15 29. Blood pressure measurements for minors 3 years of age or older and a blood
16pressure risk assessment at birth.
17 30. Risk assessment and referral for oral health issues for minors who have
18attained the age of 6 months but have not attained the age of 7 years.
19 31. Blood screening for newborns and minors who have not attained the age of
202 months.
21 32. Screening for critical congenital health defects for newborns.
22 33. Lead screenings in accordance with sub. (10).
23 34. Metabolic and hemoglobin screening and screening for phenylketonuria,
24sickle cell anemia, and congenital hypothyroidism for minors including newborns.

135. Tuberculin skin test based on risk assessment for minors one month of age
2or older.
3 36. Tobacco counseling and cessation interventions for individuals who are 5
4years of age or older.
5 37. Vision and hearing screening and assessment for minors including
6newborns.
7 38. Sexually transmitted infection and human immunodeficiency virus
8counseling for sexually active minors.
9 39. Risk assessment for sexually transmitted infection for minors who are 10
10years of age or older and screening for sexually transmitted infection for minors who
11are 16 years of age or older.
12 40. Alcohol misuse screening and counseling for minors 11 years of age or older.
13 41. Autism screening for minors who have attained the age of 18 months but
14have not attained the age of 25 months.
15 42. Developmental screening and surveillance for minors including newborns.
16 43. Psychosocial and behavioral assessment for minors including newborns.
17 44. Alcohol misuse screening and counseling for pregnant adults and a risk
18assessment for all adults.
19 45. Fall prevention and counseling and preventive medication for fall
20prevention for community-dwelling adults 65 years of age or older.
21 46. Screening and counseling for intimate partner violence for adult women.
22 47. Well-woman visits for women who have attained the age of 18 years but
23have not attained the age of 65 years and well-woman visits for recommended
24preventive services, preconception care, and prenatal care.

148. Counseling on, consultations with a trained provider on, and equipment
2rental for breastfeeding for pregnant and lactating women.
3 49. Folic acid supplement for adult women with reproductive capacity.
4 50. Iron deficiency anemia screening for pregnant and lactating women.
5 51. Preeclampsia preventive medicine for pregnant adult women at high risk
6for preeclampsia.
7 52. Low-dose aspirin after 12 weeks of gestation for pregnant women at high
8risk for miscarriage, preeclampsia, or clotting disorders.
9 53. Screenings for hepatitis B and bacteriuria for pregnant women.
10 54. Screening for gonorrhea for pregnant and sexually active females 24 years
11of age or younger and females older than 24 years of age who are at risk for infection.
12 55. Screening for chlamydia for pregnant and sexually active females 24 years
13of age and younger and females older than 24 years of age who are at risk for
14infection.
15 56. Screening for syphilis for pregnant women and adults who are at high risk
16for infection.
17 57. Human immunodeficiency virus screening for adults who have attained the
18age of 15 years but have not attained the age of 66 years and individuals at high risk
19of infection who are younger than 15 years of age or older than 65 years of age.
20 58. All contraceptives and services in accordance with sub. (17).
21 59. Any services not already specified under this paragraph having an A or B
22rating in current recommendations from the U.S. preventive services task force.
23 60. Any preventive services not already specified under this paragraph that are
24recommended by the federal health resources and services administration's Bright
25Futures project.

161. Any immunizations, not already specified under sub. (14), that are
2recommended and determined to be for routine use by the federal advisory
3committee on immunization practices.
4 (c) Subject to par. (d), no disability insurance policy and no self-insured health
5plan may subject the coverage of any of the preventive services under par. (b) to any
6deductibles, copayments, or coinsurance under the policy or plan.
7 (d) 1. If an office visit and a preventive service specified under par. (b) are billed
8separately by the health care provider, the disability insurance policy or self-insured
9health plan may apply deductibles to and impose copayments or coinsurance on the
10office visit but not on the preventive service.
11 2. If the primary reason for an office visit is not to obtain a preventive service,
12the disability insurance policy or self-insured health plan may apply deductibles to
13and impose copayments or coinsurance on the office visit.
14 3. Except as otherwise provided in this subdivision, if a preventive service
15specified under par. (b) is provided by a health care provider that is outside the
16disability insurance policy's or self-insured health plan's network of providers, the
17policy or plan may apply deductibles to and impose copayments or coinsurance on the
18office visit and the preventive service. If a preventive service specified under par. (b)
19is provided by a health care provider that is outside the disability insurance policy's
20or self-insured health plan's network of providers because there is no available
21health care provider in the policy's or plan's network of providers that provides the
22preventive service, the policy or plan may not apply deductibles to or impose
23copayments or coinsurance on the preventive service.
24 4. If multiple well-woman visits described under par. (b) 47. are required to
25fulfill all necessary preventive services and are in accordance with clinical

1recommendations, the disability insurance policy or self-insured health plan may
2not apply a deductible to or impose a copayment or coinsurance on any of those
3well-woman visits.
4Section 2977. 632.895 (14) (a) 1. i. and j. of the statutes are amended to read:
5 632.895 (14) (a) 1. i. Hepatitis A and B.
6 j. Varicella and herpes zoster.
7Section 2978. 632.895 (14) (a) 1. k. to o. of the statutes are created to read:
8 632.895 (14) (a) 1. k. Human papillomavirus.
9 L. Meningococcal meningitis.
10 m. Pneumococcal pneumonia.
11 n. Influenza.
12 o. Rotavirus.
13Section 2979. 632.895 (14) (b) of the statutes is amended to read:
14 632.895 (14) (b) Except as provided in par. (d), every disability insurance policy,
15and every self-insured health plan of the state or a county, city, town, village, or
16school district, that provides coverage for a dependent of the insured shall provide
17coverage of appropriate and necessary immunizations, from birth to the age of 6
18years,
for an insured or plan participant, including a dependent who is a child of the
19insured or plan participant.
20Section 2980. 632.895 (14) (c) of the statutes is amended to read:
21 632.895 (14) (c) The coverage required under par. (b) may not be subject to any
22deductibles, copayments, or coinsurance under the policy or plan. This paragraph
23applies to a defined network plan, as defined in s. 609.01 (1b), only with respect to
24appropriate and necessary immunizations provided by providers participating, as
25defined in s. 609.01 (3m), in the plan.

1Section 2981. 632.895 (14) (d) 3. of the statutes is amended to read:
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