New Jersey bill A 1775 requires health insurers (including hospital, medical, and health service corporations) to cover counseling and behavioral therapies for anyone receiving medication-assisted treatment (MAT) for opioid addiction. The bill mandates that this coverage be provided under the same terms and conditions as other medical treatments, prohibiting stricter limits on mental health/substance use disorder benefits compared to general medical care. It directly affects insured individuals seeking treatment for substance use disorders and requires insurers to comply with federal mental health parity standards. The law would apply to all health insurance contracts issued or renewed in New Jersey after its effective date.
This bill requires most health insurance plans in New Jersey to cover annual physical examinations for student athletes (and camp participants) as a preventive health service, similar to other routine check-ups. It applies to hospital service corporations, medical service corporations, health insurers, health maintenance organizations, and state health benefit plans. The coverage must be provided at no additional cost to the student or family, as part of standard preventive care under the insurance contract. The law takes effect 120 days after enactment, applying to policies issued or renewed after that date.
This bill (A 3412) provides lifetime health insurance coverage for live kidney donors in New Jersey. It requires the state to pay all premiums for a gold-level health plan through the New Jersey Individual Health Coverage Program, covering the donor for life with prescription drug coverage. The coverage is funded entirely by the newly established "Kidney Donor Insurance Fund" in the Department of Banking and Insurance, eliminating any cost to the donor or their employer. The bill applies to all live kidney donations occurring on or after its effective date.
This bill prohibits New Jersey health insurance companies and health plans from using a person's body weight to decide whether to cover treatment for eating disorders. It directly affects individuals seeking eating disorder care by ensuring coverage decisions aren't based on weight, which can prevent discrimination in treatment access. The law requires insurers to cover medically necessary treatments without considering weight as a factor, applying to all health plans delivered or renewed after the effective date. It takes effect 90 days after enactment, with "carrier" defined to include all authorized health insurers in the state.
This bill (A-2540, "Cancer Patient Care and Compassion Act") requires health insurance plans and Medicaid in New Jersey to cover specific cancer treatments without cost-sharing for patients with Stage III, IV, or terminal cancer. It mandates coverage for parenteral treatments (like IV medications), survivorship care plans, and other services determined by regulators. The bill also adds protections: mortgage lenders must pause foreclosure during active treatment, creditors cannot initiate collections, and tenants facing eviction can request a 45-day stay with physician certification. These provisions directly affect cancer patients and their families by removing financial barriers to care and preventing housing/financial instability during treatment. The bill is pending before the Assembly Financial Institutions and Insurance Committee.
This bill prohibits New Jersey health insurance carriers from reducing reimbursement rates for network providers during the term of existing contracts. It directly affects insurance companies and healthcare providers who have signed contracts with these insurers. The key provision prevents carriers from unilaterally lowering payments to providers for the duration of their agreements. The law takes effect on the first day of the third month following enactment and applies to all new or renewed contracts after that date.
This New Jersey bill (A 453) limits out-of-pocket costs for asthma inhalers under most health insurance plans. It requires coverage for prescribed asthma inhalers with no deductible and caps copayments or coinsurance at $35 per 30-day supply. The law applies to hospital, medical, and health service corporation plans issued or renewed in New Jersey, directly affecting asthma patients covered by these plans. Plans may lower costs further but cannot exceed this $35 limit per month.
This bill requires health insurance companies in New Jersey to provide policyholders with a written copy of any verbal agreement about coverage within 30 days of the agreement. It applies to all health insurance carriers (including HMOs and dental plans) and covers initial coverage, changes to coverage, or claim reimbursements discussed orally. The written copy must comply with existing insurance simplification rules, and policyholders gain the right to request recordings or transcripts of the verbal agreement. Policyholders also have 30 days after receiving the written copy to report any discrepancies between it and the original oral discussion.
This bill requires all health insurance plans in New Jersey to cover continuous glucose monitoring systems prescribed for treating glycogen storage disease, a rare metabolic condition. It applies to hospital service corporations, medical service corporations, health service corporations, individual health insurance policies, group health plans, and health benefits plans. The coverage must be provided at the same level as for other medical conditions, eliminating insurance denials for this specific treatment. This directly affects patients with glycogen storage disease and their insurers, ensuring access to necessary monitoring technology without extra cost barriers.
This New Jersey bill requires hospitals providing breast cancer surgical treatments (like mastectomy or lumpectomy) to give patients written notice at diagnosis - before surgery consent - about their rights to consult with any board-certified plastic surgeon (regardless of hospital or insurance network) and coverage for reconstructive surgery under state/federal law. It also prohibits health insurance contracts from blocking doctors from recommending plastic surgeons outside their network or denying reconstructive surgery coverage based solely on a surgeon’s network status. The policy applies specifically to patients undergoing treatment for breast cancer, breast cancer genes, or other breast abnormalities. Hospitals must provide this notice upon diagnosis, ensuring patients understand their options for reconstruction and coverage.
