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Bill

A 3795

Permits payment of only one co-payment or deductible for follow-up care or treatment after surgery or illness under certain health benefits plans.

2024-2025 Regular Session Introduced by Verlina Reynolds-Jackson

New Jersey bill limits health insurance co-payments and deductibles to one per episode of post-surgical or illness-related follow-up care to reduce patient out-of-pocket costs.

Introduced in the Assembly, Referred to Assembly Financial Institutions and Insurance Committee
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Bill Summary · A 3795

Legislative bill overview

Bill A 3795 would require certain health benefits plans in New Jersey to apply only a single co-payment or deductible across all follow-up care and treatment visits related to a specific surgery or illness episode, rather than charging patients separately for each visit. The bill appears designed to reduce out-of-pocket costs for patients undergoing treatment for a specific condition during a defined recovery or treatment period.

Why is this important

Follow-up care can involve multiple specialist visits, diagnostic tests, and treatments, and current insurance structures often require patients to pay separate co-payments or meet deductibles at each visit, creating significant cumulative costs during recovery. This bill addresses affordability barriers that may prevent patients from completing necessary follow-up care after major medical events. The change could meaningfully impact patient compliance with post-operative care and chronic condition management.

Potential points of contention

  • Insurance cost concerns: Insurers may argue this reduces their ability to manage costs and could lead to premium increases for all subscribers
  • Definition ambiguity: The bill's language around "certain health benefits plans" and what qualifies as related "follow-up care" for a single episode may be unclear, creating implementation and dispute challenges
  • Scope uncertainty: It's unclear whether this applies to all post-surgical follow-up or only specific procedures, and whether it covers all treatment-related visits or just primary condition visits

Compiled from official sources — confirm details with the bill’s official record.

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