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 mandates that insurance providers offer clear and accessible information about these treatments to their subscribers, ensuring that coverage is provided to the same extent as for any other medical condition.

Additionally, the Act introduces a new requirement for the School Employees Health Benefits Commission to include coverage for these menopause-related treatments in all health benefit contracts purchased after the bill's effective date. It also amends existing law to classify these treatments under the medical assistance program, ensuring comprehensive coverage. The 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. Overall, this legislation aims to enhance healthcare access and support for women experiencing these natural life stages.

Statutes affected:
Introduced: 30:4D-6