New Jersey 2024-2025 Regular Session

New Jersey Assembly Bill A5278

Introduced
2/10/25  
Refer
2/10/25  
Refer
3/20/25  
Refer
6/19/25  
Report Pass
6/19/25  

Caption

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

Impact

If enacted, A5278 will amend existing statutory provisions to ensure that health insurance policies in New Jersey must cover a wide array of treatments associated with menopause. This bill seeks to provide clarity in coverage and enhance accessibility to necessary healthcare services that could lead to improved health outcomes for women experiencing symptoms of menopause. By mandating coverage for treatments such as bone health medications and counseling, the bill advances women’s health needs within the state and encourages health service corporations to be more inclusive in their benefit offerings.

Summary

Assembly Bill A5278, known as the 'New Jersey Menopause Coverage Act', aims to expand health insurance coverage for medically necessary treatments related to perimenopause and menopause. The bill requires that health service corporation contracts provide comprehensive benefits for women diagnosed with perimenopause and menopause. This includes a variety of treatment options such as hormonal therapies, non-hormonal treatments for managing symptoms, behavioral health care services, physical therapy, and preventive services recommended by the United States Preventive Services Task Force. The intent of the legislation is to address a critical gap in healthcare for women undergoing this natural life stage.

Sentiment

The legislative sentiment around A5278 has been largely supportive, particularly among women's health advocates and healthcare professionals who recognize the importance of addressing menopause-related health issues. Supporters argue that this bill will alleviate the financial burden on women who often face significant out-of-pocket expenses for necessary treatments. However, some concerns have been raised regarding the potential impacts on insurance premiums and the economy of health service providers adapting to the new coverage requirements.

Contention

Notable points of contention surrounding A5278 include the debate over healthcare costs and the implications for insurance providers in meeting the increased coverage requirements. Critics may argue that mandating additional coverage could drive up premiums, potentially making insurance less affordable for some individuals. Proponents counter that improved health outcomes for women and preventive care measures could ultimately lower long-term healthcare costs, presenting a compelling case for the bill's passage.

Companion Bills

NJ S4148

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

Previously Filed As

NJ S4148

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

NJ HB392

Provides relative to Medicaid and private insurance coverage for perimenopausal and menopausal care (EN NO IMPACT See Note)

NJ HB1346

In casualty insurance, providing for menopause treatment coverage.

NJ AB2467

Health care coverage for menopause.

NJ HB3814

Relating to health benefit plan coverage for perimenopause and menopause medications.

NJ AB432

Menopause.

NJ A1924

Requires health insurance carriers to categorize mental health treatment and therapy received by victim of domestic violence as medically necessary treatment and provide full benefits coverage therefor.

NJ HB1345

In public assistance, providing for medical assistance coverage for menopause treatments.

NJ HB2734

Perimenopause; menopause; education

NJ A08542

Enacts the menopause awareness improvement act; establishes a menopause education program; establishes course work or training in menopausal health; directs the commissioner of labor to conduct a study on the impact of menopause on the workforce.

Similar Bills

NJ S4148

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

NJ SJR85

Designates October of each year as "Menopause Awareness Month" October 11 of each year as "Perimenopause Day," and October 18 of each year as "Postmenopause Day" in New Jersey.

NJ S4147

Permits up to three credits of continuing medical education on menopause to be used by advanced practice nurses and physicians for license renewal.

NJ A5309

Permits up to three credits of continuing medical education on menopause to be used by advanced practice nurses and physicians for license renewal.

LA HB392

Provides relative to Medicaid and private insurance coverage for perimenopausal and menopausal care (EN NO IMPACT See Note)

CA AB2467

Health care coverage for menopause.

CA AB432

Menopause.

NJ S3525

Establishes interagency council on menopause in DOH.