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Bill > S3434


NJ S3434

NJ S3434
Clarifies coverage requirements for health insurers of over-the-counter contraceptive drugs.


summary

Introduced
06/10/2024
In Committee
06/20/2024
Crossed Over
Passed
Dead
01/12/2026

Introduced Session

2024-2025 Regular Session

Bill Summary

This bill clarifies certain current law regarding coverage for over-the-counter contraceptive drugs by insurers authorized to provide health benefits in the State. Specifically, the bill clarifies that various insurers are required to provide coverage for either the requested prescriptive contraceptive drugs, devices, and products approved by the U.S. Food and Drug Administration or the therapeutic equivalents. Medical necessity for over-the-counter contraceptive drugs is also deemed to be present under the coverage of the various health insurers in the State. Additionally, point-of-sale coverage for over-the-counter female contraceptives is to be provided without cost-sharing or medical management restrictions. Lastly, the bill further delineates the type of family planning programs that provide benefits for contraceptives and establishes that Medicaid and the other family planning programs are to provide coverage for over-the-counter contraceptives and pharmacy-furnished self-administered hormonal contraceptives with no requirement for a prescription or provider order.

AI Summary

This bill clarifies coverage requirements for health insurers in New Jersey regarding over-the-counter contraceptive drugs. Specifically, it requires various insurers, including hospital service corporations, medical service corporations, health service corporations, group health insurers, and individual health insurers, to provide coverage for over-the-counter contraceptive drugs approved by the U.S. Food and Drug Administration, without requiring a prescription or provider order. The bill also deems medical necessity to be present for over-the-counter contraceptive drugs and requires point-of-sale coverage for over-the-counter female contraceptives without cost-sharing or medical management restrictions. Additionally, the bill extends these coverage requirements to Medicaid and other family planning programs administered by the Department of Human Services.

Committee Categories

Health and Social Services

Sponsors (2)

Last Action

Reported from Senate Committee, 2nd Reading (on 06/20/2024)

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