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HB 4203

INS CD-CANCER SCREENINGS

104th Regular Session Introduced by Terri Bryant and 7 co-sponsors

HB 4203 expands insurance coverage for ovarian cancer screenings, ensuring individuals at risk can access a wider range of tests without cost-sharing starting January 2024.

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Bill Summary · HB 4203

Summary of HB 4203: INS CD-CANCER SCREENINGS

Bill Information:
- Bill Number: HB 4203
- Title: INS CD-CANCER SCREENINGS
- Status: Filed with the Clerk by Rep. Norine K. Hammond
- Introduced: November 14, 2025
- Effective Date: January 1, 2028

Purpose and Intent

HB 4203 aims to amend the Illinois Insurance Code to enhance coverage for cancer screenings, specifically targeting ovarian cancer. The bill seeks to expand the definition of individuals "at risk for ovarian cancer" and to broaden the types of surveillance tests covered under health insurance policies.

Key Provisions

  1. Definition Expansion:

    • The bill adds having a high level of CA-125 (a tumor marker) from a blood test to the criteria for being considered "at risk for ovarian cancer."

  2. Surveillance Tests for Ovarian Cancer:

    • The legislation defines "surveillance tests for ovarian cancer" to include a wider range of medically viable detection methods. This includes:
      • Ultrasounds
      • Magnetic Resonance Imaging (MRIs)
      • X-rays
      • Computed Tomography (CT) scans
      • CA-125 blood test screenings
    • This replaces the previous requirement for an annual screening that was limited to:
      • CA-125 serum tumor marker testing
      • Transvaginal ultrasound
      • Pelvic examination

  3. Coverage Requirements:

    • The bill mandates that group policies of accident and health insurance, issued or renewed after January 1, 2024, must cover these surveillance tests without imposing coinsurance, copayment, or other cost-sharing requirements.

  4. Clarification of Terms:

    • The bill clarifies definitions related to prostate cancer screenings and specifies that the provisions do not apply to limited benefit coverage or policies that would disqualify high-deductible health plans from health savings account eligibility.

Who Would Be Affected

  • Individuals at Risk for Ovarian Cancer: Those with a family history of ovarian cancer, clusters of breast cancer, or who test positive for BRCA1 or BRCA2 mutations, as well as those with elevated CA-125 levels.
  • Health Insurance Policyholders: Individuals covered under group health insurance policies issued or renewed after the specified date will benefit from expanded coverage for cancer screenings.

Procedural Aspects

  • The bill was filed on November 14, 2025, and is set to take effect on January 1, 2028. This timeline allows for the necessary adjustments in insurance policy frameworks to accommodate the new coverage requirements.

Conclusion

HB 4203 represents a significant step towards improving cancer screening accessibility for individuals at risk of ovarian cancer in Illinois. By broadening the definition of at-risk individuals and expanding the types of covered surveillance tests, the bill aims to enhance early detection and potentially improve health outcomes for those affected.

Compiled from official sources — confirm details with the bill’s official record.

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