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.
House Committee Amendment No. 1: Specifies that nothing in provisions of the Illinois Insurance Code requiring coverage of certain treatments or medications prescribed to slow the progression of Alzheimer's disease or another related dementia prohibits a group or individual policy of accident and health insurance or managed care plan from requiring a pharmacist to effect substitutions of prescription drugs under certain provisions of the Pharmacy Practice Act.
House Floor Amendment No. 2: Replaces everything after the enacting clause with the provisions of the introduced bill with the following changes. Specifies that nothing in provisions of the Illinois Insurance Code requiring coverage of certain treatments or medications prescribed to slow the progression of Alzheimer's disease or another related dementia prohibits a group or individual policy of accident and health insurance or managed care plan from requiring a pharmacist to effect substitutions of prescription drugs under certain provisions of the Pharmacy Practice Act. Provides that the required coverage shall not apply to managed care plans that are under contract with the Department of Healthcare and Family Services. Amends the State Employees Group Insurance Act of 1971 to require the same coverage as provided under the Illinois Insurance Code for treatments to slow the progression of Alzheimer's disease and related dementias. Provides for repeal of existing provisions for such coverage in that Act on July 1, 2027. Effective immediately, except some provisions amending the State Employees Group Insurance Act of 1971 are effective July 1, 2027.

Statutes affected:
Introduced: 55 ILCS 5/5, 65 ILCS 5/10, 105 ILCS 5/10, 215 ILCS 5/356, 215 ILCS 125/5, 215 ILCS 130/4003, 215 ILCS 165/10
Engrossed: 5 ILCS 375/6, 55 ILCS 5/5, 65 ILCS 5/10, 105 ILCS 5/10, 215 ILCS 5/356, 215 ILCS 125/5, 215 ILCS 130/4003, 215 ILCS 165/10