This bill requires various health insurance plans in New Jersey, including those from 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-operative appointments with healthcare providers. To be eligible for this coverage, individuals must submit documentation from their physician confirming a diagnosis of lipedema, along with any necessary additional documentation from their surgeon, such as photographs and the number of lipectomies deemed necessary.

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 related to lipedema treatment. It also ensures that prior authorizations for lipectomy remain valid for one year and must be honored by subsequent insurers if a covered person changes plans. The benefits outlined in the bill must align with the current standard of care for lipedema, a chronic condition characterized by painful fat accumulation, and the bill is set to take effect six months after enactment, applying to contracts entered into or renewed thereafter.