DelawareSS 1 for SB 319153rd General Assembly (2024–2026)SenateWALLET

AN ACT TO AMEND TITLE 18, TITLE 29, AND TITLE 31 OF THE DELAWARE CODE RELATING TO COVERAGE FOR DIAGNOSTIC SERVICES AND TREATMENT FOR MENOPAUSE, PERIMENOPAUSE, AND MENOPAUSE AND PERIMENOPAUSE SYMPTOMS.

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Bill Overview

Analyzed Economic Effects

3 provisions identified: 3 benefits, 0 costs, 0 mixed.

More menopause care for Delaware Medicaid members

Beginning after December 31, 2027, covered Delaware Medicaid health benefit plans must cover medically needed menopause and perimenopause care. Covered care includes consultations, tests, medicines, behavioral health care, pelvic floor therapy, bone-health screening and treatment, prevention, counseling, and education. Drug and device coverage includes all FDA-approved products for treating symptoms. Hormone replacement coverage includes FDA-approved bioidentical products and care for menopause caused by hysterectomy; hormone pellets are excluded. Carriers cannot deny or limit medically needed hormone therapy supported by national clinical guidelines, standards of care, or peer-reviewed research. That therapy cannot require prior approval or trying another treatment first, except where federal law provides otherwise. Carriers must give members clear coverage information. Benefits must generally match assistance for other medical conditions, subject to federal law.

More menopause coverage for Delaware state employees

Beginning after December 31, 2027, Delaware's state employee health plan must cover medically needed menopause and perimenopause care. Covered care includes consultations, tests, medicines, behavioral health care, pelvic floor therapy, bone-health screening and treatment, prevention, counseling, and education. Drug and device coverage includes all FDA-approved products for treating symptoms. Hormone replacement coverage includes FDA-approved bioidentical products and care for menopause caused by hysterectomy; hormone pellets are excluded. The plan cannot deny or limit medically needed hormone therapy supported by national clinical guidelines, standards of care, or peer-reviewed research. That therapy cannot require prior approval or trying another treatment first. The carrier must provide clear coverage information, and benefits must generally match coverage for other medical conditions. Usual deductibles, coinsurance, allowable-charge limits, coordination with other coverage, and licensed or certified provider-network limits remain allowed.

More menopause coverage in private health plans

The law requires covered Delaware individual, group, and blanket health plans to cover medically needed menopause and perimenopause care. This applies to policies issued, renewed, modified, altered, amended, or reissued after December 31, 2027. Care includes consultations, tests, medicines, behavioral health care, pelvic floor therapy, bone-health screening and treatment, prevention, counseling, and education. Drug and device coverage includes all FDA-approved products for treating symptoms. Hormone replacement coverage includes FDA-approved bioidentical products and care for menopause caused by hysterectomy; hormone pellets are excluded. Plans cannot deny or limit medically needed hormone therapy supported by national clinical guidelines, standards of care, or peer-reviewed research. That therapy cannot require prior approval or trying another treatment first. Plans must provide clear coverage information and generally cover benefits like care for other medical conditions, subject to federal law. Usual deductibles, coinsurance, allowable-charge limits, coordination with other coverage, and licensed or certified provider-network limits remain allowed. Accident-only, specified-disease, hospital-indemnity, Medicare supplement, long-term care, disability-income, and other limited-benefit policies are excluded. Group employers that demonstrate a conflict with genuine religious beliefs or practices must receive an exclusion upon request. Employees must receive reasonable, timely notice of that exclusion.

Sponsors & Cosponsors

Sponsor

Nicole Poore
Democratic • Senate

Cosponsors

Alonna Berry
Democratic • House
Darius J. Brown
Democratic • Senate
Eric Buckson
Republican • Senate
Frank Burns
Democratic • House
Daniel Cruce
Democratic • Senate
Mara Gorman
Democratic • House
Stephanie L. Hansen
Democratic • Senate
Debra Heffernan
Democratic • House
Gerald W. Hocker
Republican • Senate
Kyra L. Hoffner
Democratic • Senate
Russell Huxtable
Democratic • Senate
Kamela T Smith
Democratic • House
Dave G. Lawson
Republican • Senate
S. Elizabeth Lockman
Democratic • Senate
Spiros Mantzavinos
Democratic • Senate
Eric Morrison
Democratic • House
DeShanna U Neal
Democratic • House
Trey Paradee
Democratic • Senate
Brian Pettyjohn
Republican • Senate
Marie Pinkney
Democratic • Senate
Bryant L. Richardson
Republican • Senate
Cyndie Romer
Democratic • House
Melanie Ross Levin
Democratic • House
Ray Seigfried
Democratic • Senate
Claire Snyder-Hall
Democratic • House
David P. Sokola
Democratic • Senate
Laura V. Sturgeon
Democratic • Senate
Bryan Townsend
Democratic • Senate
John "Jack" Walsh
Democratic • Senate
David L. Wilson
Republican • Senate

Roll Call Votes

All Roll Calls

Yes: 57 • No: 1

House vote • 6/25/2026

Passed (2/3 required)

Yes: 36 • No: 1

Senate vote • 6/17/2026