And yet, comprehensive menopause coverage is left entirely to the discretion of individual insurers. They are simultaneously an insurer, a care provider, and an employer with every financial and moral incentive to cover menopause care comprehensively, with published health equity commitments to match. It is a case study in what happens when menopause coverage is treated as optional. Comprehensive menopause coverage is a retention strategy for the people you can least afford to lose. The coverage gap is a choice.