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HB 3699

VITAMIN PRESCRIPTION COVERAGE

104th Regular Session Introduced by Lisa Davis and 4 co-sponsors

Illinois requires coverage for medically necessary prescribed vitamins in new/renewed plans from 2027, excluding OTC vitamins.

Rule 3-9(a) / Re-referred to Assignments
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Bill Summary · HB 3699

Summary — HB 3699 (Vitamin Prescription Coverage)

Status: Enacted (Governor signed 6/20/2025). Effective date of the Act: 1/1/2026.
Bill introduced: 2/18/2025. Chief House sponsor: Rep. Nicolle Grasse. House amendment added 3/20/2025 clarifying an OTC exclusion.

Purpose

HB 3699 requires health insurance coverage for medically necessary prescribed vitamins. The stated intent is to ensure patients who need vitamins as part of medical care can obtain them through their insurance coverage rather than paying out‑of‑pocket.

Key provisions

  • Adds Section 356z.80 to the Illinois Insurance Code: any group or individual accident & health insurance policy or managed care plan that is amended, delivered, issued, or renewed on or after January 1, 2027, must cover medically necessary prescribed vitamins.
  • The House amendment specifies that this coverage does not apply to vitamins purchased over the counter (i.e., only prescribed vitamins are covered).
  • Integrates the new coverage requirement into existing state health plan statutes:
    • Amends the State Employees Group Insurance Act (to require inclusion of this coverage in the state employee program).
    • Amends the Health Maintenance Organization Act to make HMOs subject to the new Insurance Code provision.
    • The bill’s synopsis also lists changes to the Voluntary Health Services Plans Act, the Limited Health Service Organization Act, and the Illinois Public Aid (Medicaid) Code, indicating broader applicability across plan types (the added Insurance Code section is the primary new mandate).
  • Enforcement/division of authority: existing enforcement structures under the Illinois Insurance Code and state employee plan statutes remain in place (Department of Insurance and Department of Central Management Services where applicable).

Who is affected

  • Private insurers offering group and individual accident & health policies and managed care plans (including HMOs).
  • Employers that sponsor group health plans (including the State’s employee plan).
  • Beneficiaries who require prescribed vitamins for medical treatment.
  • Potentially Medicaid/Illinois Public Aid beneficiaries if the Public Aid Code amendments (listed in the bill synopsis) are implemented.

Timeline / Implementation

  • Act effective: January 1, 2026.
  • Coverage requirement applies to policies amended/delivered/issued/renewed on or after January 1, 2027 (i.e., practical coverage obligations begin with plan renewals or new/changed policies on or after that date).

Potential impacts and considerations

  • Access: May improve access and affordability of prescribed vitamins for patients with medical indications (e.g., deficiencies, malabsorption, post‑surgical needs).
  • Cost: Insurers may face increased pharmacy/benefit costs; those costs could influence premiums, plan design, or utilization management (prior authorization, formularies, quantity limits).
  • Scope/administration: The bill covers “medically necessary prescribed vitamins,” a phrase that may require administrative definitions and could be subject to insurer medical‑necessity determinations and formulary management.
  • OTC exclusion: Vitamins purchased without a prescription are expressly not covered.

Legislative history (highlights)

  • Passed both chambers (House and Senate) in May 2025; enrolled 5/20/2025.
  • Signed by Governor: 6/20/2025.
  • Effective as an Act: 1/1/2026, with the insurance‑coverage mandate taking effect for applicable policies on or after 1/1/2027.

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

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