SB518: SB518 Insurance; health benefit policy coverage for medically necessary treatments of alopecia universalis; require

Alopecia universalis is a severe autoimmune condition that causes complete loss of body hair. Right now Georgia law does not require health insurers to cover its treatment. This bill would add a new section to Georgia's insurance code (O.C.G.A. § 33-24-59.37) requiring health insurers offering individual or group health plans in the state to cover medically necessary diagnosis and treatment costs for the condition, including FDA-approved oral medications, corticosteroids, phototherapy, and cranial prostheses (wigs used as medical devices). The coverage requirement would not apply to self-funded employer health plans governed by the federal ERISA law. Cost-sharing for alopecia treatment, such as deductibles and copayments, would have to match what applies to other covered benefits, and insurers could not impose special extra limits. The rule would apply to policies issued or renewed on or after January 1, 2027, with contracts deemed renewed by their first anniversary.

• Adds a new Code section requiring Georgia health insurers to cover medically necessary diagnosis and treatment of alopecia universalis starting January 1, 2027.
• Defines covered treatments to include FDA-approved oral medications, corticosteroids, phototherapy, and cranial prostheses.
• Exempts self-funded employer health plans regulated under the federal ERISA law from the new coverage requirement.
• Bars insurers from imposing special deductibles, coinsurance, or copayments for alopecia treatment beyond what applies to other covered benefits.
• Allows insurers to offer coverage more generous than the bill's minimum requirements without restriction.
• Applies the requirement to policies issued, delivered, or renewed on or after January 1, 2027, treating all contracts as renewed by their first anniversary.

Georgians diagnosed with alopecia universalis who need medical treatment, health insurers and HMOs that sell individual or group plans in Georgia, and employers who sponsor fully insured (non-ERISA) group health plans in the state.

People with alopecia universalis could gain guaranteed insurance coverage for medications, phototherapy, and medical wigs rather than paying out of pocket, while insurers would face a new mandated benefit and Georgians in self-funded employer plans would see no change.

• Subsection (a) defines key terms including 'alopecia universalis,' 'cost-sharing requirement,' 'covered person,' and 'health benefit policy,' and excludes ERISA self-funded employer plans from that definition.
• Subsection (b) sets the core mandate: beginning January 1, 2027, health insurers must cover medically necessary treatment costs for alopecia universalis, listing specific covered treatments.
• Subsection (c) requires alopecia coverage to use the same cost-sharing terms as other covered benefits and bars insurers from adding special extra limits just for this condition.
• Subsection (d) clarifies insurers may still offer more generous benefits than the law requires.
• Subsection (e) sets the applicability date of January 1, 2027 for new and renewed policies and states contracts are deemed renewed by their first anniversary.
• Section 2 repeals any conflicting laws.

1. 2026-02-18Senate Read and Referred (Senate)
2. 2026-02-17Senate Hopper (Senate)

• Shawn Still (R, SD-048)Primary sponsor

• health insurance coverage
• alopecia treatment
• insurance mandates
• medical cost sharing