Mandating coverage


07-Sep-2017 11:01

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However, for HMOs, the law does apply in certain situations to contracts written outside of Illinois if the HMO member is a resident of Illinois and the HMO has established a provider network in Illinois.

To determine if your HMO provides infertility benefits, you should contact the HMO directly or check your certificate of coverage.

Illinois law requires certain group insurance plans and health maintenance organizations (HMOs) to provide coverage for the diagnosis and treatment of infertility. Illinois law requires insurance companies and HMOs to provide coverage for infertility to employee groups of more than 25.

The law does not apply to self-insured employers or to trusts or insurance policies written outside Illinois.

For example, if a physician determines that one year of artificial insemination has failed and is not likely to lead to a successful pregnancy a woman shall be considered infertile for purposes of this coverage, regardless of whether she satisfies any of the other three categories of infertility.

Universal health care, sometimes referred to as universal health coverage, universal coverage, or universal care, usually refers to a health care system that provides health care and financial protection to all citizens of a particular country.



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