This bill requires various health insurance plans in New Jersey, including hospital service corporations, medical service corporations, health service corporations, and individual and group health insurance policies, to provide coverage for the treatment of lipedema. The mandated coverage includes expenses for compression garments, manual lymphatic drainage, medical nutrition therapy, mental health care, medically necessary lipectomy, and pre-and post-lipectomy appointments. To qualify for this coverage, individuals must submit documentation from their physician diagnosing lipedema, along with any necessary supporting photographs and information regarding the number of lipectomies deemed necessary by their surgeon.

Additionally, the bill prohibits insurers from denying coverage based solely on submitted photographs and requires them to provide a detailed explanation for any claim denials. It establishes that prior authorizations for lipectomy are valid for one year, provided the covered person remains eligible and there are no misrepresentations or material changes in their condition. Insurers must also honor prior authorizations granted by previous carriers. The benefits must align with the current standard of care for lipedema, and the bill is set to take effect six months after enactment, applying to contracts entered into or renewed thereafter.