Chapter 215 — INSURANCE

(215 ILCS 5/356z.3) Sec. 356z.3. Disclosure of limited benefit. An insurer that issues, delivers, amends, or renews an individual or group policy of accident and health insurance in this State after the effective date of this amendatory Act of the 92nd General Assembly and arrang…

(215 ILCS 5/356z.30) Sec. 356z.30. Coverage for hearing aids. (a) As used in this Section: "Hearing care professional" means a person who is a licensed hearing instrument dispenser, licensed audiologist, or licensed physician. "Hearing instrument" or "hearing aid" means any weara…

(215 ILCS 5/356z.30a) Sec. 356z.30a. (Repealed). (Source: P.A. 101-393, eff. 1-1-20. Repealed by P.A. 103-718, eff. 7-19-24.)

(215 ILCS 5/356z.31) Sec. 356z.31. Recovery housing for persons with substance use disorders. (a) Definitions. As used in this Section: "Substance use disorder" and "case management" have the meanings ascribed to those terms in Section 1-10 of the Substance Use Disorder Act. "Hos…

(215 ILCS 5/356z.32) Sec. 356z.32. Coverage for fertility preservation services. (a) As used in this Section: "Iatrogenic infertility" means an impairment of fertility by surgery, radiation, chemotherapy, or other medical treatment affecting reproductive organs or processes. "May…

(215 ILCS 5/356z.33) Sec. 356z.33. Coverage for epinephrine injectors. (a) 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, 2020 (the effective date of Public Act 101-281) sh…

(215 ILCS 5/356z.34) Sec. 356z.34. Coverage for cardiopulmonary monitors. A group or individual policy of accident and health insurance amended, delivered, issued, or renewed after January 1, 2020 (the effective date of Public Act 101-218) shall provide coverage for cardiopulmona…

(215 ILCS 5/356z.35) Sec. 356z.35. Long-term antibiotic therapy for tick-borne diseases. (a) As used in this Section: "Long-term antibiotic therapy" means the administration of oral, intramuscular, or intravenous antibiotics singly or in combination for periods of time in excess …

(215 ILCS 5/356z.36) Sec. 356z.36. Coverage of treatment models for early treatment of serious mental illnesses. (a) For purposes of early treatment of a serious mental illness in a child or young adult under age 26, a group or individual policy of accident and health insurance, …

(215 ILCS 5/356z.37) Sec. 356z.37. Whole body skin examination. An individual or group policy of accident and health insurance shall cover, without imposing a deductible, coinsurance, copayment, or any other cost-sharing requirement upon the insured patient, one annual office vis…

(215 ILCS 5/356z.38) Sec. 356z.38. Human breast milk coverage. (a) Notwithstanding any other provision of this Act, pasteurized donated human breast milk, which may include human milk fortifiers if indicated by a prescribing licensed medical practitioner, shall be covered under a…

(215 ILCS 5/356z.39) Sec. 356z.39. Coverage of the psychiatric Collaborative Care Model. (a) As used in this Section, "psychiatric Collaborative Care Model" means the evidence-based, integrated behavioral health service delivery method, which includes a formal collaborative arran…

(215 ILCS 5/356z.3a) (Text of Section from P.A. 104-60) Sec. 356z.3a. Billing; emergency services; nonparticipating providers. (a) As used in this Section: "Ancillary services" means: (1) items and services related to emergency medicine, anesthesiology, pathology, radiology, and …

(215 ILCS 5/356z.4) Sec. 356z.4. Coverage for contraceptives. (a)(1) The General Assembly hereby finds and declares all of the following: (A) Illinois has a long history of expanding timely access to birth control to prevent unintended pregnancy. (B) The federal Patient Protectio…

(215 ILCS 5/356z.40) Sec. 356z.40. Pregnancy and postpartum coverage. (a) An individual or group policy of accident and health insurance or managed care plan amended, delivered, issued, or renewed on or after October 8, 2021 (the effective date of Public Act 102-665) shall provid…

(215 ILCS 5/356z.40a) Sec. 356z.40a. Pregnancy as a qualifying life event for qualified health plans. Beginning with the operation of a State-based exchange in plan year 2026, a pregnant individual has the right to enroll in a qualified health plan through a special enrollment pe…

(215 ILCS 5/356z.41) Sec. 356z.41. Cost sharing in prescription insulin drugs; limits; confidentiality of rebate information. (a) As used in this Section, "prescription insulin drug" means a prescription drug that contains insulin and is used to control blood glucose levels to tr…

(215 ILCS 5/356z.42) Sec. 356z.42. (Repealed). (Source: P.A. 101-625, eff. 1-24-20. Repealed internally, eff. 12-31-20.)

(215 ILCS 5/356z.43) Sec. 356z.43. (Repealed). (Source: P.A. 102-813, eff. 5-13-22. Repealed internally, eff. 1-1-22.)

(215 ILCS 5/356z.44) Sec. 356z.44. Vitamin D testing. (a) As used in this Section, "vitamin D testing" means vitamin D blood testing that measures the level of vitamin D in an individual's blood. (b) A group or individual policy of accident and health insurance or managed care pl…

(215 ILCS 5/356z.45) Sec. 356z.45. Coverage for patient care services provided by a pharmacist. 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, 2023 shall provide coverage f…

(215 ILCS 5/356z.46) Sec. 356z.46. Biomarker testing. (a) As used in this Section: "Biomarker" means a characteristic that is objectively measured and evaluated as an indicator of normal biological processes, pathogenic processes, or pharmacologic responses to a specific therapeu…

(215 ILCS 5/356z.47) Sec. 356z.47. Coverage for pancreatic cancer screening. 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, 2022 shall provide coverage for medically necess…

(215 ILCS 5/356z.48) Sec. 356z.48. Colonoscopy coverage. (a) A group policy of accident and health insurance that is amended, delivered, issued, or renewed on or after January 1, 2022 shall provide coverage for a colonoscopy that is a follow-up exam based on an initial screen whe…

(215 ILCS 5/356z.49) Sec. 356z.49. A1C testing. (a) As used in this Section, "A1C testing" means blood sugar level testing used to diagnose prediabetes, type 1 diabetes, and type 2 diabetes and to monitor management of blood sugar levels. (b) A group or individual policy of accid…

(215 ILCS 5/356z.4a) Sec. 356z.4a. Coverage for abortion. (a) Except as otherwise provided in this Section, no individual or group policy of accident and health insurance that provides pregnancy-related benefits may be issued, amended, delivered, or renewed in this State after th…

(215 ILCS 5/356z.4b) Sec. 356z.4b. Billing for long-acting reversible contraceptives. (a) In this Section, "long-acting reversible contraceptive device" means any intrauterine device or contraceptive implant. (b) Any individual or group policy of accident and health insurance or …

(215 ILCS 5/356z.5) Sec. 356z.5. Prescription inhalers. (a) In this Section, "prescription inhaler" means a prescribed medical device that delivers inhaled medications used to treat breathing for persons suffering from asthma or other life-threatening bronchial ailments. "Prescri…

(215 ILCS 5/356z.50) Sec. 356z.50. Comprehensive cancer testing. (a) As used in this Section: "Comprehensive cancer testing" includes, but is not limited to, the following forms of testing: (1) Targeted cancer gene panels. (2) Whole-exome genome testing. (3) Whole-genome sequenci…

(215 ILCS 5/356z.51) Sec. 356z.51. Coverage for port-wine stain treatment. (a) A group or individual policy of accident and health insurance or managed care plan amended, delivered, issued, or renewed on or after January 1, 2022 shall provide coverage for treatment to eliminate o…

(215 ILCS 5/356z.53) Sec. 356z.53. Coverage for home health services. 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, 2024 shall provide coverage for access to home health s…

(215 ILCS 5/356z.54) Sec. 356z.54. Coverage for breast reduction surgery. 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, 2024 shall provide coverage for medically necessary…

(215 ILCS 5/356z.55) Sec. 356z.55. Coverage for cleft lip and cleft palate. (a) As used in this Section, "medically necessary care and treatment" to address congenital anomalies associated with a cleft lip or palate, or both, includes: (1) oral and facial surgery, including recon…

(215 ILCS 5/356z.56) Sec. 356z.56. Coverage for hormonal and non-hormonal therapy to treat menopause. A group or individual policy of accident and health insurance or a managed care plan that is amended, delivered, issued, or renewed in this State shall provide coverage for medic…

(215 ILCS 5/356z.57) Sec. 356z.57. Pediatric palliative care. (a) A group or individual policy of accident and health insurance or a managed care plan amended, delivered, issued, or renewed on or after January 1, 2024 shall provide coverage for community-based pediatric palliativ…

(215 ILCS 5/356z.58) Sec. 356z.58. Prenatal vitamins coverage. A group or individual policy of accident and health insurance that is amended, delivered, issued, or renewed on or after January 1, 2024 that provides coverage for prescription drugs shall provide coverage for prenata…

(215 ILCS 5/356z.59) Sec. 356z.59. Coverage for continuous glucose monitors. (a) A group or individual policy of accident and health insurance or a managed care plan that is amended, delivered, issued, or renewed before January 1, 2026 shall provide coverage for medically necessa…

(215 ILCS 5/356z.6) Sec. 356z.6. Bone mass measurement; osteoporosis. A group or individual policy of accident and health insurance amended, delivered, issued, or renewed after the effective date of this amendatory Act of the 93rd General Assembly must provide coverage for medica…

(215 ILCS 5/356z.60) Sec. 356z.60. Coverage for abortifacients, hormonal therapy, and human immunodeficiency virus pre-exposure prophylaxis and post-exposure prophylaxis. (a) As used in this Section: "Abortifacients" means any medication administered to terminate a pregnancy as p…

(215 ILCS 5/356z.61) Sec. 356z.61. Coverage for liver disease screening. 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, 2025 shall provide coverage for preventative liver d…

(215 ILCS 5/356z.62) Sec. 356z.62. Coverage of preventive health services. (a) A policy of group health insurance coverage or individual health insurance coverage as defined in Section 5 of the Illinois Health Insurance Portability and Accountability Act shall, at a minimum, prov…

(215 ILCS 5/356z.63) Sec. 356z.63. Coverage of pharmacy testing, screening, vaccinations, and treatment. 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, 2025 shall provide c…

(215 ILCS 5/356z.64) Sec. 356z.64. Coverage for compression sleeves. 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, 2025 shall provide coverage for compression sleeves that…

(215 ILCS 5/356z.65) Sec. 356z.65. Coverage for reconstructive services. (a) As used in this Section, "reconstructive services" means treatments performed on structures of the body damaged by trauma to restore physical appearance. (b) A group or individual policy of accident and …

(215 ILCS 5/356z.66) Sec. 356z.66. Proton beam therapy. (a) As used in this Section: "Medically necessary" has the meaning given to that term in the Prior Authorization Reform Act. "Proton beam therapy" means a type of radiation therapy treatment that utilizes protons as the radi…

(215 ILCS 5/356z.67) Sec. 356z.67. Coverage of prescription estrogen. (a) 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, 2025 and that provides coverage for prescription dr…

(215 ILCS 5/356z.68) Sec. 356z.68. Home saliva cancer screening. (a) As used in this Section, "home saliva cancer screening" means an outpatient test that utilizes an individual's saliva to detect biomarkers for early-stage cancer. (b) An individual or group policy of accident an…

(215 ILCS 5/356z.69) Sec. 356z.69. Coverage for children with neuromuscular, neurological, or cognitive impairment. A group or individual policy of accident and health insurance amended, delivered, issued, or renewed on or after January 1, 2025 shall provide coverage for therapy,…

(215 ILCS 5/356z.7) (was 215 ILCS 5/370r) Sec. 356z.7. Prescription drugs; cancer treatment. No group policy of accident or health insurance that provides coverage for prescribed drugs approved by the federal Food and Drug Administration for the treatment of certain types of canc…

(215 ILCS 5/356z.70) Sec. 356z.70. Coverage of no-cost mental health prevention and wellness visits. (a) A group or individual policy of accident and health insurance or managed care plan that is amended, delivered, issued, or renewed on or after January 1, 2025 shall provide cov…