New Jersey 2024-2025 Regular Session

New Jersey Senate Bill S3226

Introduced
5/13/24  

Caption

Requires insurance coverage of diapers when medically necessary.

Impact

The implementation of S3226 could significantly alter the landscape of health insurance coverage in New Jersey. By requiring insurers to cover diapers when prescribed as medically necessary, this bill could alleviate some financial burdens faced by families with children or adults needing long-term diaper usage due to medical conditions. It addresses equity in health care by recognizing the necessity of this coverage for certain populations who are often overlooked in discussions surrounding health benefits.

Summary

Senate Bill S3226, introduced in New Jersey, mandates that health insurance plans provide coverage for diapers deemed medically necessary by a healthcare provider. This legislation aims to address the needs of individuals, particularly children and some adults with specific medical conditions, who require diapers beyond early childhood. The bill emphasizes the responsibility of health insurers to ensure coverage without imposing prior authorization or other utilization management requirements, thereby streamlining access for those in need.

Contention

While proponents of S3226 argue it is a necessary step toward comprehensive healthcare, there may be concerns regarding the financial implications for insurance companies. Critics could articulate worries about potential increases in insurance premiums or the administrative burden of determining medical necessity. Additionally, the potential for varying interpretations of what constitutes a medical necessity for diaper coverage may lead to disputes between insurers and policyholders, necessitating clear guidelines to avoid ambiguity.

Notable_points

Ultimately, S3226 represents a progressive shift toward inclusive healthcare policies. It highlights the essential nature of personal care products for individuals with medical needs and seeks to eliminate barriers to obtaining necessary supplies. Should this bill pass, it may set a precedent for future legislation focused on other necessary health-related provisions, enhancing overall accessibility and support for affected populations.

Companion Bills

NJ A3681

Same As Requires insurance coverage of diapers when medically necessary.

NJ S1607

Carry Over Requires insurance coverage of diapers when medically necessary.

Previously Filed As

NJ S1607

Requires insurance coverage of diapers when medically necessary.

NJ A3681

Requires insurance coverage of diapers when medically necessary.

NJ A1844

Requires insurance coverage of epinephrine for persons aged 18 or younger when medically necessary.

NJ A1908

Requires insurance coverage of epinephrine for persons aged 18 or younger when medically necessary.

NJ A5278

Establishes "New Jersey Menopause Coverage Act"; requires health insurance coverage of medically necessary perimenopause and menopause treatments.

NJ S4148

Establishes "New Jersey Menopause Coverage Act"; requires health insurance coverage of medically necessary perimenopause and menopause treatments.

NJ A5133

Requires health insurance and Medicaid coverage for the treatment of stuttering.

NJ S3558

Requires health insurance and Medicaid coverage for the treatment of stuttering.

NJ A4781

Requires health insurance coverage for certain obesity treatments.

NJ S3259

Requires health insurance coverage for certain obesity treatments.

Similar Bills

NJ A3681

Requires insurance coverage of diapers when medically necessary.

NJ S1607

Requires insurance coverage of diapers when medically necessary.

CA AB935

Telehealth: mental health.

CA AB2360

Telehealth: mental health.

NJ S1045

Requires certain licensed health care professionals and health care facilities to screen adolescents and young adults for symptoms of depression.

NJ A2762

Requires certain licensed health care professionals and health care facilities to screen adolescents and young adults for symptoms of depression.

NJ A5300

Requires regional diagnostic and treatment center for child abuse and neglect to establish mobile team to respond to certain hospital requests to perform forensic child abuse examinations.

NJ S4093

Requires regional diagnostic and treatment center for child abuse and neglect to establish mobile team to respond to certain hospital requests to perform forensic child abuse examinations.