This bill (S 2672) requires all health insurance plans in New Jersey - including hospital service corporations, medical service corporations, individual policies, group plans, and health maintenance organizations - to cover planned home childbirth costs. It mandates coverage for services provided by healthcare providers (like midwives, nurses, and doctors), doulas, and necessary medical equipment, at the same level as other covered medical services. The law applies to all insurance contracts issued or renewed in New Jersey after its effective date, regardless of whether premiums can be adjusted. This directly affects insurance companies and Medicaid by expanding coverage options for individuals choosing home births.
S 855, "Michelle's Law," requires all health insurance plans in New Jersey to cover mammograms when recommended by a healthcare provider. It mandates coverage for a baseline mammogram at age 40, annual mammograms for women 40 and older, and mammograms for women under 40 with specific risk factors (like family history or dense breast tissue) as determined by their doctor. The law also requires coverage for additional tests like ultrasounds or MRIs after a mammogram if medically necessary due to breast density, abnormal results, or other risk factors. Insurance companies may review the medical necessity of these additional tests but cannot deny coverage for recommended screenings. This applies to all group and individual health insurance plans sold in New Jersey.
This bill requires health insurance plans covering groups of 50+ people in New Jersey to include infertility treatment coverage. It mandates coverage for specific services like IVF, embryo transfer, medications, and up to four egg retrievals per person, with limitations for certain procedures (e.g., IVF only after trying less expensive options and under age 45). Religious employers may opt out of covering some procedures (like IVF) if it conflicts with their beliefs, but must provide clear written notice in 10-point font. The law applies to hospital and medical service corporation contracts but excludes Medicaid programs like NJ FamilyCare. It aims to standardize infertility coverage under existing pregnancy-related benefit rules.
S 959, the "New Jersey Respect for Physicians Act," requires health insurance companies to respond to doctors' and hospitals' requests for prior authorization of medical services within strict timeframes. For most cases (inpatient or outpatient care), insurers must approve or deny requests within 48 hours - reducing the previous 15-day deadline - and must contact providers by phone within 4 hours to discuss the request. If insurers miss these deadlines, the service is automatically approved, and insurers must pay for the care. The bill directly affects healthcare providers seeking authorization and insurance companies handling those requests, aiming to reduce delays in patient care.
This bill requires most health insurance plans in New Jersey to cover medically necessary hearing aids for children under 15 years old. It applies to hospital service corporations, medical service corporations, health service corporations, individual policies, and group health plans. Key provisions include coverage for hearing aids for each ear when prescribed by a doctor or audiologist, a $1,000 annual benefit limit per hearing aid per ear, and allowing patients to pay extra for more expensive devices without penalty to providers. The bill does not extend coverage to adults, despite its title suggesting "all ages."
This bill requires health insurance carriers in New Jersey to create a 60-day special enrollment period when a provider leaves their network. It directly affects insured individuals who would lose access to their current healthcare providers due to a network change. The special period begins 60 days before the carrier-provider contract expires, giving enrollees time to switch plans. The Department of Banking and Insurance will determine how carriers notify affected individuals about this window. The law takes effect immediately upon enactment.
S 722, now law as P.L.2025, c.200, requires all health insurance plans in New Jersey to cover medically necessary treatments for perimenopause and menopause. It directly affects New Jersey residents with health insurance, mandating coverage for specific services like hormone therapy (including HRT), non-hormonal medications, pelvic floor therapy, bone health screenings, and preventive care for related conditions such as osteoporosis or heart disease. Insurance plans must cover these treatments "to the same extent as for any other medical condition," with clear information provided to subscribers. The law applies to hospital, medical, health service, and individual insurance policies issued or renewed in New Jersey.
S 2257 requires all health insurance plans and Medicaid in New Jersey to cover family planning and reproductive health care services - including abortion, contraception, counseling, and related medical care - without cost-sharing. It directly affects health insurers, Medicaid, and medical providers by mandating comprehensive coverage and prohibiting medical malpractice insurance companies from penalizing providers for offering legally protected reproductive care. The bill defines covered services to include abortion procedures, emergency care, genetic testing, and well-baby care, while explicitly excluding childbirth. This policy aims to remove financial barriers, particularly for low-income individuals, people of color, and those in rural areas, ensuring access to reproductive health services without insurance restrictions.
This bill allows New Jersey residents to purchase health insurance policies sold by insurers licensed in other states (referred to as "foreign health insurers"). It directly affects residents seeking coverage options and employers who may reimburse employees for such policies. The key provision guarantees that buying insurance through this method satisfies any legal requirement for maintaining health coverage, including employer or state mandates. The bill takes effect 90 days after enactment but is currently pending in the Senate Commerce Committee.
This New Jersey bill (S 494) requires health insurance plans that cover cancer chemotherapy to also cover scalp cooling systems. These systems are devices used to prevent hair loss during chemotherapy treatment. The law applies to all major insurance types (including individual, group, employer-sponsored, and hospital service plans) that already cover chemotherapy, mandating coverage "to the same extent as for any other condition." It directly affects insurers, who must provide this coverage, and cancer patients, who gain access to a therapy that may reduce treatment-related hair loss.
