Do NJ health plans cover autism, infertility treatments?

• New Jersey one of 26 states that require autism coverage
• 23 states %28including New Jersey%29 mandate coverage for bariatric surgery

If you or a family member needs autism therapy, infertility treatments or bariatric surgery, you're in luck if you live in New Jersey.

The state requires health insurance plans to cover all of those services, unlike many other states. Overall, according to a new study by researchers at the University of Pennsylvania, New Jersey's basic plans are among the most comprehensive in the U.S.

Why it matters

The Affordable Care Act requires health plans to include a package of 10 "essential health benefits." But the federal law, which took effect this year, doesn't get into specifics. Until 2016, those decisions are left to the states. As a result, the researchers found, coverage for certain services varies widely from state to state.

What's covered

Of the 11 specific services there researchers looked at, New Jersey requires coverage for seven. Only three states require more: Illinois, New Mexico and Nevada, all of which mandate eight of the 11. A few states require only one or two.

The seven services that New Jersey requires, and the total number of states that mandate them, are: chiropractic care (45); treatment for TMJ disorders (31); hearing aids (26); autism spectrum disorder services, including Applied Behavioral Analysis (26); nutrition counseling (25); bariatric surgery (23) and infertility treatments (19.)

Find out if you're ready for weight-loss surgery

What's optional

The four services that New Jersey doesn't require, and the total number of states that do, are: routine foot care (20); private-duty nursing (19); acupuncture (5) and weight-loss programs (5.)

The bottom line

Depending on your plan, you might have coverage for more or all of these services. The state requirements simply set a minimum of what plans have to include.

Shannon Mullen: 732-643-4278; smullen@njpressmedia.com