S 564 requires all health insurance plans sold in New Jersey - including hospital service contracts, medical service plans, individual policies, group plans, and HMOs - to cover prenatal genetic testing during the first trimester of pregnancy. It specifically mandates coverage for three test types: carrier screening (blood/tissue tests for inherited disorders), nuchal translucency screening, and chorionic villus sampling. The law states coverage must be provided "to the same extent as for any other medical condition," meaning no additional out-of-pocket costs for these tests. This bill directly affects pregnant individuals seeking genetic screening and all health insurers operating in New Jersey, though it remains pending in the Senate Commerce Committee after introduction on January 13, 2026.
This bill requires health insurance plans in New Jersey to cover enrollment in recovery high school alternative education programs as part of mental health/substance use disorder treatment. It applies when a certified counselor, physician, or school official determines placement is clinically appropriate using standard medical criteria. Insurance must cover these programs under the same terms as other medical benefits, without stricter limits than those applied to general medical care. The law amends existing insurance coverage requirements to include this specific educational option for students with substance use disorders. It directly affects students seeking recovery-focused education and health insurers providing coverage in New Jersey.
This bill establishes a state fund to provide lifetime health insurance coverage for live kidney donors in New Jersey. It requires the state to cover all premiums for a gold-level health plan (including prescription drugs) through the New Jersey Individual Health Coverage Program, with no cost to donors or their employers. The Kidney Donor Insurance Fund, created in the Department of Banking and Insurance, will pay for these premiums using state funds. The coverage applies to all live kidney donations occurring on or after the bill's effective date.
This bill requires all health insurance carriers in New Jersey (including major health plans and state programs) to cover hospitalization costs for coronavirus (COVID-19) without any cost-sharing. It directly affects individuals hospitalized due to COVID-19 by eliminating deductibles, copayments, and coinsurance for these expenses. The key provision mandates that insurers cover all related hospitalization costs for eligible patients as defined in the bill. This applies immediately to all health plans issued or purchased on or after the effective date. The policy change removes financial barriers for COVID-19 hospital care.
This New Jersey bill (S 2998) requires health insurers to cover all FDA-approved contraceptive drugs, devices, and related services without cost-sharing. It specifically mandates no deductibles, copays, or prior authorization for over-the-counter contraceptives at the point of sale, while also covering prescription options and related services like counseling and device insertion. The law applies to all hospital and medical service corporations offering health insurance in New Jersey, directly affecting subscribers who use contraception. Insurers must cover these services at the same level as other preventive care, with no medical necessity review needed for over-the-counter products.
This bill requires health insurance plans in New Jersey to cover medically necessary ovarian cancer screening for symptomatic women or those at high risk. It mandates coverage for specific tests including annual pelvic exams, ultrasounds, and blood marker tests, on the same terms as other medical conditions. The law applies to individual/group health insurance policies, health maintenance organizations (HMOs), and state health benefit plans purchased by the State Health Benefits Commission. It takes effect for policies issued or renewed after the bill's effective date.
This bill requires health insurance plans in New Jersey to cover prescription drugs for "serious mental illness" (including schizophrenia, bipolar disorder, major depression, and PTSD) without prior authorization or step therapy protocols. It directly affects individuals with these diagnoses who rely on insurance for mental health medications. Key provisions ban insurers from forcing patients to try lower-cost treatments first (step therapy) or requiring pre-approval for covered medications. The bill also mandates insurers to report how they apply medical necessity standards for mental health coverage to ensure parity with physical health benefits. This creates immediate, concrete changes to medication access for covered mental health conditions.
S 1275 requires all health insurance plans in New Jersey (including hospital, medical, and health service corporation plans) to cover diagnostic and supplemental breast examinations without cost-sharing. Diagnostic exams evaluate abnormalities found in screenings or detected otherwise, while supplemental exams screen high-risk patients (e.g., those with dense breasts or family history) when no abnormality exists. The bill mandates coverage "to the same extent as for any other sickness" under insurance contracts, eliminating deductibles, copays, or coinsurance for these specific exams. This directly affects New Jersey residents with health insurance who require these medically necessary breast screenings.
S 712 requires New Jersey's Department of State to create a public "Reproductive Health Travel Advisory" to help residents traveling while pregnant make informed decisions. The advisory will categorize all U.S. states using a color-coded system: "Blue" (full access without legal risk), "Yellow" (restricted access with potential legal consequences), and "Red" (extreme restrictions risking denial of emergency care). It will detail each state's laws on abortion bans, waiting periods, insurance coverage, and legal protections for patients and providers. The advisory must be posted on the state website and updated whenever another state changes its reproductive healthcare laws. This directly affects New Jersey residents who may need to travel during pregnancy for medical emergencies.
New Jersey bill S 598 requires health insurance plans to cover diagnosis and treatment for two specific pediatric neurological conditions: PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections) and PANS (Pediatric Acute-onset Neuropsychiatric Syndrome). The bill mandates coverage for treatments including antibiotics, behavioral therapies, immunomodulating medicines, plasma exchange, and intravenous immunoglobulin therapy (IVIG), provided by a treating physician. Insurance plans must cover these expenses "to the same extent as for any other condition," applying to hospital service, medical service, health service, individual, group, and health benefits plans. This directly affects patients diagnosed with PANDAS or PANS and all health insurance providers operating in New Jersey.
