Bill > A5278

This bill establishes the "New Jersey Menopause Coverage Act," which requires health insurance providers in New Jersey to cover a comprehensive range of medically necessary treatments for perimenopause and menopause. The bill mandates that health insurance contracts, including those for hospital services, medical services, health services, individual and group health plans, and state employee health benefits, must provide coverage for women diagnosed with perimenopause or menopause. Covered treatments include hormone therapies, non-hormonal medications, behavioral health services, pelvic floor physical therapy, bone health treatments, preventative services with an "A" or "B" rating from the United States Preventive Services Task Force, and counseling about menopause management. The bill defines menopause as the permanent end of a female's menstrual cycle, diagnosed after 12 consecutive months without a period, and perimenopause as the transitional period leading to menopause characterized by hormonal fluctuations and menstrual cycle changes. Insurance providers must offer clear and accessible information about these treatments and provide benefits for perimenopause and menopause services at the same level as other medical conditions. The act will take effect 90 days after enactment, with some specific plans being effective from January 1, 2027, ensuring that women in New Jersey have comprehensive health insurance coverage for menopause-related medical needs.

Budget and Finance, Business and Industry

https://www.njleg.state.nj.us/bill-search/2024/A5278