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Bill

HB 3814

Relating to health benefit plan coverage for perimenopause and menopause medications.

89th Legislature (2025) Introduced by Aicha Davis and 7 co-sponsors

Texas bill mandates health insurance coverage of perimenopause and menopause medications without higher cost-sharing than standard prescriptions.

Referred to Insurance
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Bill Summary · HB 3814

Legislative bill overview

HB 3814 requires health benefit plans in Texas to cover medications prescribed to treat perimenopause and menopause symptoms without imposing higher cost-sharing requirements than those applied to other prescription medications. The bill aims to ensure equitable insurance coverage for hormone replacement therapies and other menopause-related treatments by preventing discriminatory coverage practices.

Why is this important

Menopause and perimenopause affect millions of Texas women, often causing significant quality-of-life impacts including hot flashes, sleep disruption, and mood changes. Without insurance coverage mandates, patients may face substantial out-of-pocket costs for treatments, potentially limiting access to medical care and creating disparities in who can afford symptom management.

Potential points of contention

  • Insurance industry costs: Health insurers may argue that mandated coverage increases premiums for all plan participants and reduces their flexibility in managing drug formularies
  • Scope and specificity: Unclear which medications qualify (HRT, SSRIs, gabapentin, etc.) and whether the bill adequately defines perimenopause treatment, potentially creating implementation disputes
  • Cost-sharing equity comparison: Defining what constitutes "higher" cost-sharing than other medications may be subjective and difficult to enforce consistently across different plan types

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

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