October 15, 2025

New York Large Group Insured Policies Must Cover Chemotherapy-Related Scalp Cooling Devices in 2026

Employee Benefits

3 min read

New York Large Group Insured Policies Must Cover Chemotherapy-Related Scalp Cooling Devices in 2026

Summary: New York Governor Kathy Hochul signed legislation (Assembly Bill or AB 430) in February 2025, requiring large group medical insurance policies issued in New York to cover scalp cooling systems for the preservation of hair during cancer chemotherapy treatment, beginning January 1, 2026.

With the passage of AB 430, New York becomes the first state in the nation to mandate coverage of scalp cooling systems during chemotherapy treatment for fully insured large group medical policies.

Read on for more information.

AB 430

AB 430^[1] amends the New York State insurance law for large group medical policies^[2] issued in New York, requiring them to cover scalp cooling systems used in connection with cancer chemotherapy treatment when the policy provides coverage for cancer chemotherapy treatment.

Definition of “scalp cooling system”

A “scalp cooling system” under AB 430 is defined as “any device used to cool the human scalp to prevent or reduce hair loss during cancer chemotherapy treatment, provided that such device is designed and intended for repeated use and is primarily and customarily used to serve a medical purpose.”

Cost-Sharing

Scalp cooling system coverage under AB 430 may be subject to annual policy cost-sharing requirements, including deductibles, coinsurance, and copayments, as long as they are consistent with other benefits under the policy.

Effective Date

AB 430 will be effective for large group medical policies issued, renewed, modified, altered, or amended in New York on or after January 1, 2026.

Exemptions

AB 430 does not apply to:

self-funded group health plans (including level-funded group health plans) governed under ERISA,^[3]
fully insured group medical policies issued in other states, even if the policy covers participants residing in or working in New York, and
specified disease coverage policies (since these policies are generally not considered “comprehensive-type” medical coverage, and generally do not cover cancer chemotherapy coverage, as AB 430 specifically requires in both instances).

"Large Group" Note: New York (along with California, Colorado, and Vermont) expanded their definition of “small employer” from 1-50 employees to 1-100 employees for their "small group market" insurance policies.

This means that for fully insured policies issued in New York, "large group" requirements apply to employers with 101+ employees.

Employer Considerations

Employers with fully insured large group medical policies issued in New York should be aware of this scalp cooling system mandate for the large group insurance market, the first such state mandate in the nation.

To provide a broad cost context here, the Centers for Medicare & Medicaid Services published a final rule in 2022 citing estimated “costs of around $1,900 to $2,400 associated with calibration and fitting” of a scalp cooling device cap.^[4]

As the January 1, 2026 effective date approaches for AB 430, employers with fully insured large group medical policies issued in New York should direct any questions regarding this new coverage mandate to their medical insurance carriers, including questions regarding any potential impact to policy premium costs.

Risk Strategies is committed to keeping employers informed and up-to-date. Reach out to your Risk Strategies account team with any questions, or contact us directly here.

[1] AB 430 also amends the New York State insurance law for individual medical policies to require scalp cooling systems used in connection with cancer chemotherapy treatment.

[2] Section 3221 of the New York State insurance law.

[3] ERISA means the Employee Retirement Income Security Act of 1974.

[4] https://www.govinfo.gov/content/pkg/FR-2022-11-23/pdf/2022-23918.pdf

The contents of this article are for general informational purposes only and Risk Strategies Company makes no representation or warranty of any kind, express or implied, regarding the accuracy or completeness of any information contained herein. Any recommendations contained herein are intended to provide insight based on currently available information for consideration and should be vetted against applicable legal and business needs before application to a specific client.

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