HB988: HB988 State employees; require health benefit plan to cover hormone replacement therapy for biological women experiencing perimenopause and menopause when such therapy is ordered or prescribed

Georgia's state health benefit plan, which covers state employees, teachers, and other public workers, does not currently have a specific requirement to cover hormone replacement therapy for perimenopause and menopause. This bill would add a new section to Georgia law (O.C.G.A. § 45-18-4.3) requiring the plan to cover this therapy for biological women when a licensed physician orders or prescribes it. The bill defines hormone replacement therapy broadly, covering synthetic, biological, or bioidentical hormones used to replace hormones lost during perimenopause and menopause, ease symptoms, or protect against related health conditions. The new coverage would be subject to the same deductibles, coinsurance, copayments, and utilization review already used for other benefits under the plan. The coverage requirement would begin January 1, 2027, and the law overall would take effect July 1, 2026, applying to policies issued or renewed on or after that date.

• Adds a new section to Georgia law requiring the state health benefit plan to cover hormone replacement therapy for biological women with perimenopause or menopause.
• Limits the coverage requirement to therapy that is ordered or prescribed by a licensed physician.
• Defines hormone replacement therapy to include synthetic, biological, or bioidentical hormone treatments that replace lost hormones, ease symptoms, or guard against related diseases.
• Allows the plan to apply its normal deductibles, coinsurance, copayments, and utilization review to this new coverage rather than making it fully free of cost-sharing.
• Sets the coverage requirement to start January 1, 2027, while the broader law takes effect July 1, 2026.

State employees, teachers, and other public workers enrolled in Georgia's state health benefit plan, along with the plan administrators who set coverage rules; the requirement applies specifically to biological women experiencing perimenopause or menopause who receive a prescription or order from a licensed physician.

If enacted, state health plan members going through perimenopause or menopause would have a guaranteed right to hormone replacement therapy coverage rather than relying on the plan's discretion, though they would still pay any normal deductibles, copays, or coinsurance and go through utilization review.

• Section 1 adds new Code Section 45-18-4.3 to Title 45, defining 'hormone replacement therapy' and 'state health benefit plan' for purposes of the new requirement.
• Section 1(b) requires the state health benefit plan to cover hormone replacement therapy for biological women with perimenopause or menopause when ordered or prescribed by a licensed physician, beginning January 1, 2027.
• Section 1(c) states the new benefit is subject to the same deductibles, coinsurance or copayment provisions, and utilization review as other similar covered benefits.
• Section 2 sets the Act's effective date as July 1, 2026, applying to policies or contracts issued, delivered, or renewed on or after that date.
• Section 3 repeals any conflicting laws.

1. 2026-01-27House Second Readers (House)
2. 2026-01-16House First Readers (House)
3. 2026-01-15House Hopper (House)

• Beth Camp (R, HD-135)Primary sponsor
• Jan Jones (R, HD-047)
• Leesa Hagan (R, HD-156)
• Bethany Ballard (R, HD-147)
• Kimberly New (R, HD-040)
• Carmen Rice (R, HD-139)

• state employee health benefits
• menopause coverage
• hormone replacement therapy
• health insurance mandates
• women's health