IllinoisSB0126104th General Assembly (2025–2026)SenateWALLET

INS CD-ALZHEIMER'S TREATMENT

Sponsored By: Laura M. Murphy (Democratic)

Signed by Governor

Summary

Amends the Illinois Insurance Code. Provides that a group or individual policy of accident and health insurance or a managed care plan that is amended, delivered, issued, or renewed on or after January 1, 2027 shall provide coverage for all medically necessary diagnostic testing and U.S. Food and Drug Administration-approved treatments or medications prescribed to slow the progression of Alzheimer's disease or another related dementia, in accordance with the U.S. Food and Drug Administration label, as determined by a physician licensed to practice medicine in all its branches. Provides that coverage of U.S. Food and Drug Administration-approved treatments or medications prescribed to slow the progression of Alzheimer's disease or another related dementia shall not be subject to step therapy. Amends the Counties Code, the Illinois Municipal Code, the School Code, the Health Maintenance Organization Act, the Limited Health Service Organization Act, and the Voluntary Health Services Plans Act to require coverage under those provisions. Effective immediately.

assignmentsinsurance

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Bill Overview

Analyzed Economic Effects

3 provisions identified: 3 benefits, 0 costs, 0 mixed.

More Alzheimer’s coverage in health plans

For policies amended, delivered, issued, or renewed starting January 1, 2027, qualifying individual and group plans must cover Alzheimer’s care. The law also applies these requirements to covered health maintenance organizations, limited health service organizations, and health service plan corporations. Coverage includes medically necessary testing and doctor-prescribed, FDA-approved treatments that slow Alzheimer’s or related dementia, used according to FDA labeling. Plans cannot require patients to try another treatment first, but pharmacists retain authority for specified generic-drug and interchangeable-biologic substitutions. The requirement excludes managed care plans under contract with the Illinois Department of Healthcare and Family Services.

More dementia coverage for public employees

The law extends Alzheimer’s and related dementia coverage requirements to school employee health benefits. It also covers county and municipal employee plans when the local government is self-insured. These plans must cover medically necessary testing and doctor-prescribed, FDA-approved treatments to slow the disease, following FDA labeling. Plans cannot require patients to try another treatment first; specified generic-drug and interchangeable-biologic substitutions remain allowed.

Temporary Alzheimer’s coverage for state employees

Beginning July 1, 2025, the Illinois State Employees Group Insurance Program must cover eligible Alzheimer’s and related dementia care. Coverage includes medically necessary, FDA-approved treatments or medicines prescribed by a doctor to slow the disease. It also includes testing the doctor needs to decide whether treatment is appropriate. The program cannot require patients to try another treatment first. This special coverage requirement is repealed July 1, 2027.

Sponsors & Cosponsors

Sponsor

  • Laura M. Murphy

    Democratic • Senate

Cosponsors

  • Abdelnasser Rashid

    Democratic • House

  • Adriane L. Johnson

    Democratic • Senate

  • Amy L. Grant

    Republican • House

  • Ann M. Williams

    Democratic • House

  • Anna Moeller

    Democratic • House

  • Anne Stava

    Democratic • House

  • Anthony DeLuca

    Democratic • House

  • Barbara Hernandez

    Democratic • House

  • Bob Morgan

    Democratic • House

  • Camille Y. Lilly

    Democratic • House

  • Carol Ammons

    Democratic • House

  • Christopher Belt

    Democratic • Senate

  • Dagmara Avelar

    Democratic • House

  • Dave Vella

    Democratic • House

  • Emanuel "Chris" Welch

    Democratic • House

  • Graciela Guzmán

    Democratic • Senate

  • Jaime M. Andrade, Jr.

    Democratic • House

  • Janet Yang Rohr

    Democratic • House

  • Javier L. Cervantes

    Democratic • Senate

  • Jawaharial Williams

    Democratic • House

  • Jennifer Sanalitro

    Republican • House

  • Joyce Mason

    Democratic • House

  • Julie A. Morrison

    Democratic • Senate

  • Karina Villa

    Democratic • Senate

  • Katie Stuart

    Democratic • House

  • Kevin John Olickal

    Democratic • House

  • Laura Ellman

    Democratic • Senate

  • Linda Holmes

    Democratic • Senate

  • Lindsey LaPointe

    Democratic • House

  • Margaret Croke

    Democratic • House

  • Mark L. Walker

    Democratic • Senate

  • Martha Deuter

    Democratic • House

  • Martin J. Moylan

    Democratic • House

  • Mary Edly-Allen

    Democratic • Senate

  • Mary Gill

    Democratic • House

  • Matt Hanson

    Democratic • House

  • Maura Hirschauer

    Democratic • House

  • Maurice A. West, II

    Democratic • House

  • Meg Loughran Cappel

    Democratic • Senate

  • Michael Crawford

    Democratic • House

  • Michael J. Kelly

    Democratic • House

  • Michelle Mussman

    Democratic • House

  • Mike Simmons

    Democratic • Senate

  • Napoleon Harris III

    Democratic • Senate

  • Natalie A. Manley

    Democratic • House

  • Nicholas K. Smith

    Democratic • House

  • Nicole La Ha

    Republican • House

  • Nicolle Grasse

    Democratic • House

  • Norma Hernandez

    Democratic • House

  • Paul Faraci

    Democratic • Senate

  • Rick Ryan

    Democratic • House

  • Sally J. Turner

    Republican • Senate

  • Sara Feigenholtz

    Democratic • Senate

  • Seth Lewis

    Republican • Senate

  • Sharon Chung

    Democratic • House

  • Stephanie A. Kifowit

    Democratic • House

  • Sue Scherer

    Democratic • House

  • Terra Costa Howard

    Democratic • House

  • Tracy Katz Muhl

    Democratic • House

Roll Call Votes

All Roll Calls

Yes: 195 • No: 0

House vote • 5/20/2025

Third Reading - Short Debate - Passed

Yes: 113 • No: 0

House vote • 4/29/2025

Do Pass / Short Debate Insurance Committee;

Yes: 15 • No: 0

Senate vote • 4/3/2025

Third Reading - Passed;

Yes: 55 • No: 0

Senate vote • 3/19/2025

Do Pass as Amended Insurance;

Yes: 12 • No: 0

Actions Timeline

  1. Public Act . . . . . . . . . 104-0001

    6/9/2025Senate
  2. Effective Date July 1, 2027; ;Some Provisions

    6/9/2025Senate
  3. Effective Date June 9, 2025; ;Some Provisions

    6/9/2025Senate
  4. Governor Approved

    6/9/2025Senate
  5. Sent to the Governor

    6/9/2025Senate
  6. Passed Both Houses

    5/20/2025Senate
  7. Third Reading - Short Debate - Passed 113-000-000

    5/20/2025House
  8. Added Alternate Co-Sponsor Rep. Kevin John Olickal

    5/15/2025House
  9. Added Alternate Co-Sponsor Rep. Norma Hernandez

    5/15/2025House
  10. Placed on Calendar Order of 3rd Reading - Short Debate

    5/13/2025House
  11. Second Reading - Short Debate

    5/13/2025House
  12. Added Alternate Co-Sponsor Rep. Maurice A. West, II

    5/13/2025House
  13. Added Alternate Co-Sponsor Rep. Matt Hanson

    5/12/2025House
  14. Added Alternate Co-Sponsor Rep. Carol Ammons

    5/9/2025House
  15. Added Alternate Co-Sponsor Rep. Abdelnasser Rashid

    5/9/2025House
  16. Added Alternate Co-Sponsor Rep. Sue Scherer

    5/9/2025House
  17. Added Alternate Co-Sponsor Rep. Anna Moeller

    5/9/2025House
  18. Added Alternate Co-Sponsor Rep. Rick Ryan

    5/9/2025House
  19. Added Alternate Co-Sponsor Rep. Bob Morgan

    5/9/2025House
  20. Added Alternate Co-Sponsor Rep. Sharon Chung

    5/8/2025House
  21. Added Alternate Co-Sponsor Rep. Jawaharial Williams

    5/2/2025House
  22. Added Alternate Co-Sponsor Rep. Terra Costa Howard

    5/1/2025House
  23. Added Alternate Co-Sponsor Rep. Tracy Katz Muhl

    5/1/2025House
  24. Added Alternate Co-Sponsor Rep. Barbara Hernandez

    5/1/2025House
  25. Added Alternate Co-Sponsor Rep. Jaime M. Andrade, Jr.

    4/30/2025House

Bill Text

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