5 ILCS 375/6.11C

(5 ILCS 375/6.11C)

Sec. 6.11C. Coverage for injectable medicines to improve glucose or weight loss. Beginning on July 1, 2024, the State Employees Group Insurance Program shall provide coverage for all types of medically necessary, as determined by a physician licensed to practice medicine in all its branches, injectable medicines prescribed on-label or off-label to improve glucose or weight loss for use by adults diagnosed or previously diagnosed with prediabetes, gestational diabetes, or obesity. To continue to qualify for coverage under this Section, the continued treatment must be medically necessary, and covered members must, if given advance, written notice, participate in a lifestyle management plan administered by their health plan. This Section does not apply to individuals covered by a Medicare Advantage Prescription Drug Plan.

(Source: P.A. 103-8, eff. 1-1-24; 103-564, eff. 11-17-23.)