ILL LEG Pregnancy and Postpartum Care


On May 25, ILL LEG passed bill on pregnancy and postpartum coverage.


  • ILL LEG passed bill HB 5142 making provisions to pregnancy and postpartum care.
  • Amends ILL LEG 215-5-356z.40, ILL LEG 305-5-5-16.7, ILL LEG 305-5-5-18.10, and ILL LEG 305-5-5-18.5 on pregnancy and postpartum, doula, nutrition coverage.
  • Bill Provisions
  • Coverage for postpartum services apply for at least one year after end of pregnancy.
  • Abortion care may not impose any deductible, coinsurance, waiting period, or other cost-sharing limitation, except to extent coverage would disqualify HSA eligibility.
  • Certified professional midwife services covered under the medical assistance program.
  • Not required to cover over $8,000 for doula visits each pregnancy/postpartum period.
  • Outpatient coverage, other than home births, to be provided without cost sharing, except for inpatient services for mental health services or substance use disorders.
  • Legislative History
  • On Feb. 8, 2024, bill introduced in House; on Apr. 18, 2024, bill passed in House.
  • On Apr. 19, 2024, bill introduced in Senate; on May 23, 2024, bill passed in Senate.
  • On May 25, 2024, House concurred with amendments, bill passed both chambers.
  • Effectiveness
  • Effective Jan. 1, 2026, except certain Public Aid Code changes effective Jan. 1, 2025.
  • Jul. 2024 ILL LEG Governor Approval
  • On Jul. 29, 2024, ILL LEG reported governor approved bill, Public Act 103-0720.
  • Takes effect Jan. 1, 2026, except Section 5-18.5 of ILL public aid code on Jan. 1, 2025.

Regulators ILL LEG
Entity Types Ins
Reference Bill, Public Act 103-0720, 7/29/2024; Bill, HB5142, 5/25/2024; Citation: *ILL LEG* 215-5-356z.40, 305-5-5-16.7, 305-5-5-18.5, 305-5-5-18.10;
Functions Claims/Accelerated Benefits; Compliance; Legal; Operations; Product Administration; Reporting
Countries United States of America
Category
State
Products Insurance; Insurance-Health
Regions Am
Rule Type Final
Rule Date 5/25/2024
Effective Date 1/1/2025
Rule Id 213624
Linked to N/A
Reg. Last Update 7/29/2024
Report Section US Consumer

Last substantive update on 08/02/2024