Governor Murphy signed A5235/S3627 to expand coverage to include infertility services.
New Jersey Governor Phil Murphy recently signed A5235/S3627 to expand requirements for health insurance coverage in the state to include infertility services.
The legislation requires that many plans provide benefits relating to pregnancy healthcare services.
The health insurance coverage requirements apply to certain private sector health insurance companies, including those under state regulation. They must now provide group plans with more than 50 people with pregnancy-related benefits. This also applies to plans in the School Employees’ Health Benefits Program and the State Health Benefits Program. The benefits include any services that have to do with infertility in accordance with guidelines from the American Society for Reproductive Medicine and according to the recommendations of a physician.
Among the covered services are different forms of in vitro fertilization, genetic testing, intrauterine insemination, and embryo transfers, among others. The new legislation requires that infertility services be covered for the partner of someone who has successfully reversed a voluntary sterilization procedure. Moreover, the bill also mandates that nothing in “infertility’s” definition can be used for the delay or denial of treatment to any person, regardless of sexual orientation or relationship status. The legislation also prohibits insurers from placing restrictions on infertility services based on a patient’s age.
The health insurance expansion broadens the coverage mandates for fertility services under PL 2019, c. 306.
“Making fertility services more accessible and affordable is another step in New Jersey’s comprehensive approach to strengthening reproductive health care and reproductive freedom. There are many different paths toward starting a family, each defined by their own unique challenges and joys,” said Murphy. “For those who struggle with infertility and for same-sex couples, the possibility of starting a family is deeply impacted by the availability and accessibility of infertility care and other medical services that, without coverage, can be extremely costly. Today’s bill will create new opportunities for families across New Jersey to take on one of the hardest and most rewarding jobs there is — parenthood.”
“With this legislation, we are putting critical fertility services within reach for individuals and families in New Jersey. Those struggling with infertility or in need of medical services to start a family should not have to refinance their home or spend through their savings to achieve their dreams of parenthood,” added Lieutenant Governor Tahesha Way regarding the health insurance expansion. “With today’s action, we are making critical fertility treatments accessible and affordable for New Jersey families.”
