IL SB3611

Prohibits insurers from denying or refusing otherwise covered services for autism spectrum disorder diagnosis and treatment in individuals under 21 years of age solely based on the location where services are provided.

Prohibits insurers from denying or refusing otherwise covered habilitative services for children under 19 years of age with congenital, genetic, or early acquired disorders solely based on the location where services are provided.

Maintains existing coverage requirements for autism spectrum disorder treatment with a maximum annual benefit of $36,000 (adjusted annually for inflation), subject to standard copayments, deductibles, and coinsurance.

Requires insurers to apply consistent medical necessity determinations for autism treatment as used for other covered diseases, with appeals reviewed by a physician with expertise in autism spectrum disorder treatment modalities.

Applies to group and individual accident and health insurance policies and managed care plans amended, delivered, issued, or renewed after the effective date of the 95th General Assembly.