IL HB1565

Creates new Illinois Insurance Code Section 356z.61 requiring group and individual health insurance policies and managed care plans amended, delivered, issued, or renewed on or after January 1, 2025 to cover at least one therapeutic equivalent version of vaginal estrogen in their formulary.

Requires insurers to cover medically necessary vaginal estrogen products without cost-sharing that exceeds the cost-sharing for erectile dysfunction drugs, except when such coverage would disqualify a high-deductible health plan from health savings account eligibility.

Adds Section 356z.61 to required health benefits coverage under the State Employees Group Insurance Act, Counties Code, Illinois Municipal Code, School Code, Health Maintenance Organization Act, Limited Health Service Organization Act, Voluntary Health Services Plans Act, and Illinois Public Aid Code.

Designates the Department of Insurance as the enforcement authority for the new vaginal estrogen coverage requirements across affected insurance programs and entities.