NJ A5790

Mandates health insurance coverage for lipedema treatment expenses including compression garments for affected extremities, manual lymphatic drainage, medical nutrition therapy, mental health care, medically necessary lipectomy procedures, and pre- and post-lipectomy physician appointments

Limits documentation requirements for coverage to a physician's diagnosis of lipedema and, for surgical treatment, surgeon documentation including supporting photographs and the number of medically necessary lipectomies

Prohibits insurers from denying coverage solely based on submitted photographs and requires detailed explanations for any coverage denials

Requires insurers to cover all lipectomies deemed medically necessary by the patient's surgeon without restricting the amount of fat removed during procedures

Applies to all major health insurance types in New Jersey, including hospital service corporations, medical service corporations, health maintenance organizations, individual and group policies, small employer plans, and State and School Employees' Health Benefits programs, effective six months after enactment