IL HB5492

Requires individual and group health insurance policies issued or renewed on or after January 1, 2028 to cover up to a 12-month supply of prescription hormone therapy dispensed at one time, including necessary self-administration supplies.

Defines prescription hormone therapy as FDA-approved drugs used to suppress, increase, or replace hormones, but explicitly excludes GLP-1 and GLP-1 receptor agonists (weight loss medications).

Mandates pharmacists dispense up to 12 months of hormone therapy at a patient's request, with exceptions for patient preference, prescriber instructions, acute supply shortages, or controlled substances.

Extends coverage requirements to the State Employees Group Insurance Program and Medicaid under the Illinois Public Aid Code.

Allows insurers to limit refills in the last quarter of a plan year if a 12-month supply has already been dispensed and permits continued use of drug utilization management strategies.