(5 ILCS 375/6.16)
    Sec. 6.16. Human breast milk coverage.
    (a) Notwithstanding any other provision of this Act, pasteurized donated human breast milk, which may include human milk fortifiers if indicated by a prescribing licensed medical practitioner, shall be covered under a health plan for persons who are otherwise eligible for coverage under this Act if the covered person is an infant under the age of 6 months, a licensed medical practitioner prescribes the milk for the covered person, and all of the following conditions are met:
        (1) the milk is obtained from a human milk bank that
    
meets quality guidelines established by the Human Milk Banking Association of North America or is licensed by the Department of Public Health;
        (2) the infant's mother is medically or physically
    
unable to produce maternal breast milk or produce maternal breast milk in sufficient quantities to meet the infant's needs or the maternal breast milk is contraindicated;
        (3) the milk has been determined to be medically
    
necessary for the infant; and
        (4) one or more of the following applies:
            (A) the infant's birth weight is below 1,500
        
grams;
            (B) the infant has a congenital or acquired
        
condition that places the infant at a high risk for development of necrotizing enterocolitis;
            (C) the infant has infant hypoglycemia;
            (D) the infant has congenital heart disease;
            (E) the infant has had or will have an organ
        
transplant;
            (F) the infant has sepsis; or
            (G) the infant has any other serious congenital
        
or acquired condition for which the use of donated human breast milk is medically necessary and supports the treatment and recovery of the infant.
    (b) Notwithstanding any other provision of this Act, pasteurized donated human breast milk, which may include human milk fortifiers if indicated by a prescribing licensed medical practitioner, shall be covered under a health plan for persons who are otherwise eligible for coverage under this Act if the covered person is a child 6 months through 12 months of age, a licensed medical practitioner prescribes the milk for the covered person, and all of the following conditions are met:
        (1) the milk is obtained from a human milk bank that
    
meets quality guidelines established by the Human Milk Banking Association of North America or is licensed by the Department of Public Health;
        (2) the child's mother is medically or physically
    
unable to produce maternal breast milk or produce maternal breast milk in sufficient quantities to meet the child's needs or the maternal breast milk is contraindicated;
        (3) the milk has been determined to be medically
    
necessary for the child; and
        (4) one or more of the following applies:
            (A) the child has spinal muscular atrophy;
            (B) the child's birth weight was below 1,500
        
grams and he or she has long-term feeding or gastrointestinal complications related to prematurity;
            (C) the child has had or will have an organ
        
transplant; or
            (D) the child has a congenital or acquired
        
condition for which the use of donated human breast milk is medically necessary and supports the treatment and recovery of the child.
(Source: P.A. 101-511, eff. 1-1-20.)