The New Jersey Menopause Coverage Act requires health insurance plans, including various types of health benefit contracts, to provide coverage for medically necessary treatments related to perimenopause and menopause. This coverage 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 these benefits be offered to the same extent as for any other medical condition, ensuring comprehensive support for individuals experiencing these natural life stages. Additionally, health insurance providers must offer clear and accessible information about the covered treatments.

The Act also establishes a requirement for the School Employees Health Benefits Commission to include similar coverage in health insurance contracts purchased after the bill's effective date. It amends existing law to expand medical assistance programs to include these new benefits, ensuring that individuals receiving assistance are well-informed about their coverage options. The bill clarifies the definitions of menopause and perimenopause, 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 legislation will take effect 90 days after enactment and will apply to policies and contracts issued or renewed thereafter.

Statutes affected:
Introduced: 30:4D-6