Effective Date: January 1, 2026 (for insurance policies issued or renewed on/after this date)

Key Provisions

• Requires group and individual health insurance policies or managed-care plans amended, delivered, issued, or renewed on or after Jan 1 2026 to provide coverage for medically necessary hormonal and non-hormonal therapy to treat menopausal symptoms when prescribed by a qualified healthcare provider.
• Coverage must include all FDA-approved modalities (oral, transdermal, topical, vaginal rings, etc.).
• Expands Medicaid coverage for hormone therapy after hysterectomy-induced menopause under the Illinois Public Aid Code.

Why It Matters

This landmark legislation makes Illinois one of the first U.S. states to mandate comprehensive insurance coverage for menopause care. It closes long-standing gaps that excluded many women from access to treatment for symptoms such as hot flashes, night sweats, and sleep disturbances.

By specifying coverage for both hormonal and non-hormonal therapies, the law ensures more equitable care for women regardless of their medical background or risk factors.

For Healthcare Professionals & Employers

• Providers should document “medically necessary” menopause therapy to support insurance claims.
• Employers must update benefits communications to reflect new coverage requirements for 2026 renewals.
• Expect an increase in consultations related to menopause management and treatment options.

What it is: A statewide, binding mandate that requires both Medicaid and private health plans in Louisiana to cover medically necessary care for menopause and perimenopause, and removes common insurance hurdles for hormone therapy.

Status & Effective Window: Approved July 1, 2025; effective 90 days after legislative adjournment. Codified at 22 M.R.S. §1700-F.

What the Law Does

• Directs the Maine Center for Disease Control and Prevention to create and disseminate educational materials on perimenopause and menopause in both electronic and physical formats.
• Materials must cover symptoms, evidence-based treatments, when to contact a provider, the biological process, and how to talk with family and friends about perimenopause/menopause.
• Requires collaboration with OB/GYNs, primary care clinicians, nurse practitioners, physician associates, and community-based programs and hospitals across Maine.
• Includes a biennial appropriation of $20,000 per year (FY 2025–26 and 2026–27) to support development and distribution of these materials.

Why It Matters

This is an education-first law aimed at closing the information gap for midlife health. While it does not mandate insurance coverage, it equips residents and clinicians with consistent, statewide resources that can improve recognition of symptoms, reduce stigma, and guide timely, evidence-based care.

For Clinicians, Employers & Community Programs

• Integrate Maine CDC materials into patient education, discharge packets, and community workshops.
• Train frontline staff to recognize symptoms and refer to up-to-date resources.
• Employers can incorporate the materials into wellness portals and manager toolkits.

Status & Effective Window: Enacted and chaptered as 2025 Oregon Laws, Chapter 500; applies to health benefit plans issued, renewed, or extended on/after January 1, 2026.

What the Law Requires

• All health benefit plans must include coverage of treatment for perimenopause, menopause, and postmenopause.
• Covered treatments explicitly include: hormone therapy (estrogen-only and estrogen-plus-progestogen combinations), SSRIs/SNRIs, vaginal estrogen, osteoporosis prevention/treatment medications, neurokinin-3 antagonists, topical hormone therapy, and bioidentical hormones.
• Coverage is limited to FDA-approved drugs.
• Updates statutes for the Public Employees’ Benefit Board (PEBB) and the Oregon Educators Benefit Board (OEBB) to align with the new coverage requirements.

Why It Matters

Oregon’s law sets a clear statewide baseline for evidence-based menopause care. It standardizes coverage across plans and explicitly names newer and established therapies, reducing denials and helping clinicians match patients to effective, FDA-approved options.

For Clinicians, Employers & Plans

• Audit formularies and EHR order sets to ensure the listed therapies are covered without unnecessary hurdles.
• Update benefits communications for 2026 plan years; coordinate with PEBB/OEBB where applicable.
• Document clinical rationale for therapy selection to streamline claims and appeals.

Status & Effective Date: Signed into law June 24, 2025; effective upon passage.

What the Law Does

• Adds menopause and menopause-related conditions to Rhode Island’s Fair Employment Practices accommodations statute (§28-5-7.4).
• Makes it an unlawful employment practice to refuse reasonable accommodations for menopause or related medical conditions, unless doing so would pose an undue hardship.
• Prohibits requiring an employee to take leave if another reasonable accommodation is available.
• Requires employers to provide a written, conspicuously posted notice of rights, including the right to accommodations for menopause-related conditions.
• Clarifies that “related conditions” include management of vasomotor symptoms (e.g., hot flashes).

Why It Matters

Rhode Island is the first state to explicitly protect workers experiencing menopause, aligning employment practices with women’s midlife health needs and reducing barriers to retention and advancement.

For Clinicians, Employers & HR

• Coordinate documentation that supports requested accommodations tied to symptom management.
• Update handbooks, onboarding materials, and workplace postings to reflect the new rights.
• Train supervisors on interactive accommodation processes and examples such as schedule adjustments, access to temperature-regulated spaces, or additional break time.

Effective Date: HB 1971 – July 27, 2025 (12-month supply refill law); SR 8657 adopted April 23, 2025.

Key Provisions

• House Bill 1971 allows Washingtonians to obtain up to a 12-month supply of covered prescription hormone therapy in one refill, beginning January 2026 (excluding certain controlled substances capped at six months).
• Senate Resolution 8657 recognizes menopause as a public health concern, urging more research, clinician training, and workplace awareness initiatives across the state.

Why It Matters

Washington’s dual measures expand access to hormone therapy while formally recognizing menopause as a state-level health and equity issue. This coordinated policy approach reduces refill barriers and sets a precedent for integrating menopause into broader public-health planning.

For Healthcare Professionals & Employers

• Clinicians may adjust follow-up schedules as patients gain access to 12-month therapy supplies.
• Insurers and HR departments must update benefit documents to reflect the new refill requirements.
• Employers can anticipate greater awareness and demand for menopause-inclusive policies and wellness programs.