In a significant bipartisan move, an Illinois House committee has unanimously moved a bill that would expand insurance coverage for Alzheimer’s disease treatments forward, aiming to ensure that all Illinoisans with health insurance have access to the latest FDA-approved therapies and essential diagnostic testing.
The proposed legislation builds on a law passed last year that required the State Employees Group Insurance Program to cover all medically necessary, FDA-approved treatments and medications designed to slow the progression of Alzheimer’s disease. That law, which also mandates coverage for diagnostic testing to help physicians determine the most appropriate treatment, is set to take effect for state employees on July 1, 2025.
The newly advanced bill, House Bill 1360, seeks to extend these requirements to all health insurance plans in Illinois, both public and private. If enacted, the measure would:
- Require all group and individual health insurance policies, as well as managed care plans, to cover FDA-approved treatments and medications for Alzheimer’s and related dementias, as prescribed by a licensed physician.
- Prohibit insurers from imposing step therapy protocols, meaning patients would not have to try and fail other treatments before accessing the latest approved therapies.
- Mandate coverage for any diagnostic testing deemed medically necessary by physicians to determine the best course of treatment.
- Expand protections to employees of self-insured counties, municipalities, and school districts, in addition to state employees.
The bill is now poised to move to the full House for further consideration.
If passed into law, the expanded coverage requirements for private and public insurance plans would take effect beginning January 1, 2027, ensuring that patients across the state have access to the latest advancements in Alzheimer’s treatment.
