14132.14. (Added by Stats. 2026, Ch. 27, Sec. 86.)

(a)Federal Food and Drug Administration-approved…#

(a) Federal Food and Drug Administration-approved treatments for menopausal symptoms are covered benefits under the Medi-Cal program, subject to medical necessity. These include all of the following:

(1) Hormone therapy, including combination estrogen and hormone medicines, combination estrogen and progestin medicines, estrogen-only and progestin-only medicines, vaginal estrogen, and topical hormone therapy. This does not include glucagon-like peptide-1 or glucagon-like peptide-1 receptor agonists used solely for weight loss.

(2) Low-dose antidepressants.

(3) Anticonvulsants.

(4) Medications to prevent or treat osteoporosis.

(5) Nonhormonal medications for vasomotor-related symptoms.

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14132.14. (Added by Stats. 2026, Ch. 27, Sec. 86.)

Official source

(a)Federal Food and Drug Administration-approved…#

(a) Federal Food and Drug Administration-approved treatments for menopausal symptoms are covered benefits under the Medi-Cal program, subject to medical necessity. These include all of the following:

(1) Hormone therapy, including combination estrogen and hormone medicines, combination estrogen and progestin medicines, estrogen-only and progestin-only medicines, vaginal estrogen, and topical hormone therapy. This does not include glucagon-like peptide-1 or glucagon-like peptide-1 receptor agonists used solely for weight loss.

(2) Low-dose antidepressants.

(3) Anticonvulsants.

(4) Medications to prevent or treat osteoporosis.

(5) Nonhormonal medications for vasomotor-related symptoms.

(b)The department shall establish and maintain a policy to…#

(b) The department shall establish and maintain a policy to reimburse providers for provision of services related to menopause care, including services integrated with primary care and obstetrician-gynecologist services. The policy shall consider current clinical care recommendations from the Menopause Society or other nationally recognized professional association, and shall identify billing codes for services commonly used to treat symptoms resulting from menopause.

(c)Coverage pursuant to this subdivision shall be provided…#

(c) Coverage pursuant to this subdivision shall be provided without discrimination on the basis of gender expression or identity.

(d)For purposes of this section, “menopause” includes…#

(d) For purposes of this section, “menopause” includes perimenopause, menopause, and postmenopause.

(e)Notwithstanding Chapter 3.5 (commencing with Section…#

(e) Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, the department may implement this section by means of all-county letters, plan letters, plan or provider bulletins, or similar instructions, without taking any further regulatory action.

(f)This section shall be implemented only to the extent…#

(f) This section shall be implemented only to the extent that any necessary federal approvals are obtained, and federal financial participation is available and not otherwise jeopardized.