Bill
Bill > S4148
NJ S4148
Establishes "New Jersey Menopause Coverage Act"; requires health insurance coverage of medically necessary perimenopause and menopause treatments.
summary
Introduced
02/25/2025
02/25/2025
In Committee
02/25/2025
02/25/2025
Crossed Over
Passed
Dead
Introduced Session
2024-2025 Regular Session
Bill Summary
This bill establishes the "New Jersey Menopause Coverage Act" and requires health insurance coverage of medically necessary perimenopause and menopause treatments. Under the bill, health insurance carriers (including insurance companies, hospital service corporations, medical service corporations, health service corporations, health maintenance organizations authorized to issue health benefits plans in New Jersey, entities contracted to administer health benefits in connection with the State Health Benefits Program and School Employees' Health Benefits Program, and the New Jersey FamilyCare Program) will be required to cover medically necessary treatment for perimenopause, menopause, and symptoms associated with perimenopause and menopause, including but not limited to: (1) hormonal therapies such as hormone replacement therapy and bioidentical hormone treatments; (2) non-hormonal treatments, including medications to manage menopausal symptoms; (3) behavioral health care services; (4) pelvic floor physical therapy; (5) bone health treatments, including screenings, medications, and supplements, due to hormonal changes related to perimenopause and menopause; (6) preventative services for early detection and treatment of health conditions related to perimenopause and menopause such as cardiovascular disease, osteoporosis, and cancer; and (7) counseling and education regarding menopause management. The bill also requires that carriers are to provide clear and accessible information to covered persons regarding perimenopause and menopause treatments. For the purpose of this bill, "menopause" means the natural and permanent end of a female's menstrual cycle, diagnosed by a licensed medical provider after 12 consecutive months without a menstrual period. "Perimenopause" means the transitional period leading to menopause, marked by fluctuating hormone levels and changes in menstrual cycles.
AI Summary
This bill establishes the "New Jersey Menopause Coverage Act," which requires health insurance carriers to provide comprehensive coverage for perimenopause and menopause treatments. The bill mandates that insurance plans cover a wide range of medically necessary services, including hormonal and non-hormonal therapies, behavioral health care, pelvic floor physical therapy, bone health treatments, preventative services, and counseling. Specifically, the bill applies to various types of health insurance plans, such as hospital service corporations, medical service corporations, health service corporations, individual and group health policies, and state employee health benefit programs. The legislation defines "menopause" as the permanent end of menstrual cycles (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 carriers must not only cover these treatments but also provide clear and accessible information about available perimenopause and menopause-related services. The bill will take effect 90 days after enactment and will apply to insurance policies and contracts delivered, issued, executed, or renewed on or after that date.
Committee Categories
Business and Industry
Sponsors (3)
Last Action
Introduced in the Senate, Referred to Senate Commerce Committee (on 02/25/2025)
Official Document
bill text
bill summary
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bill summary
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bill summary
| Document Type | Source Location |
|---|---|
| State Bill Page | https://www.njleg.state.nj.us/bill-search/2024/S4148 |
| BillText | https://pub.njleg.gov/Bills/2024/S4500/4148_I1.HTM |
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