The New Jersey Menopause Coverage Act requires health insurance plans, including various health benefit contracts, to provide coverage for medically necessary treatments related to perimenopause and menopause. This encompasses a wide range of services such as hormonal therapies, non-hormonal treatments, behavioral health care, pelvic floor physical therapy, bone health treatments, preventative services for related health conditions, and counseling on menopause management. The bill ensures that these benefits are offered to the same extent as any other medical condition under the respective contracts. Additionally, it mandates that insurance providers supply clear and accessible information to subscribers about the treatments available for perimenopause and menopause.

The legislation also amends existing law to include menopause-related treatments in the medical assistance program, ensuring they are covered similarly to other medical conditions. Definitions of menopause and perimenopause are clarified, with menopause defined as the permanent end of a female's menstrual cycle after 12 consecutive months without a period, and perimenopause as the transitional phase leading to menopause. The act will take effect 90 days after enactment and will apply to policies and contracts issued or renewed thereafter, enhancing healthcare access and support for individuals experiencing these conditions.

Statutes affected:
Introduced: 30:4D-6