IL HB5295

Amends the Illinois Insurance Code Section 356z.56 to require coverage for both hormonal and non-hormonal therapy to treat menopausal symptoms in group and individual health insurance policies and managed care plans issued or renewed on or after January 1, 2026

Requires that recommended therapy be from a qualified health care provider licensed under Illinois law and proven safe and effective in peer-reviewed scientific studies

Mandates coverage include all FDA-approved administration modalities including oral, transdermal, topical, and vaginal rings

Transitions coverage requirements: policies amended, delivered, issued, or renewed between January 1, 2024 and January 1, 2026 must cover hormone therapy only for menopause induced by hysterectomy; January 1, 2026 forward applies broader menopausal symptom coverage

Adds Section 5-52 to the Illinois Public Aid Code requiring the medical assistance program to provide coverage for medically necessary hormone therapy to treat menopause induced by hysterectomy