Bill > S2998

This bill clarifies and expands health insurance coverage requirements for contraceptives, ensuring that various types of insurers, including hospital service corporations, medical service corporations, health service corporations, group health insurers, individual health insurers, and health maintenance organizations (HMOs), must cover both prescription and over-the-counter female contraceptives approved by the U.S. Food and Drug Administration (FDA). It mandates that if a prescription contraceptive has a therapeutic equivalent, coverage must be provided for either the requested prescription or its equivalent. Importantly, coverage for over-the-counter contraceptives will be provided without requiring a prescription or provider order, and medical necessity for these over-the-counter options will be automatically presumed. Furthermore, point-of-sale coverage for over-the-counter female contraceptives must be offered without any cost-sharing (like copayments or deductibles) or medical management restrictions, meaning insurers cannot impose extra hurdles or charges for these products. The bill also specifies that Medicaid and other state-administered family planning programs, such as PlanFirst and Cover All Kids, will cover over-the-counter contraceptives and self-administered hormonal contraceptives without a prescription or provider order, and these provisions will take effect 90 days after enactment, applying to new and renewed policies and contracts thereafter.

Health and Social Services

https://www.njleg.state.nj.us/bill-search/2026/S2998