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WMOK News: The New Illinois Laws – Part 17 – Health Mandates Sweep In: Expanded Coverage for Menopause, Infertility, and Screenings
This installment brings the final, wide-ranging health insurance changes taking effect on January 1, 2026. Illinois lawmakers have passed a series of bills that collectively reshape the landscape of required medical coverage, providing relief and greater access to care for thousands of residents in areas often excluded or under-covered by insurance plans.
These mandates apply to fully insured group and individual health policies issued or renewed in the state.
Key Expansions to Health Insurance Coverage
The new laws create four major categories of mandatory coverage that insurers must adhere to:
1. Addressing Drug Shortages
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Brand-Name Coverage Required: If a generic drug or its therapeutic equivalent becomes unavailable due to a supply shortage (as listed by the FDA), insurers are now required to cover the brand-name version of the drug until the generic supply issue is resolved. This eliminates the burden on patients to pay high brand-name prices or face severe health risks when generic medications are out of stock.
2. Reproductive and Fertility Care
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Infertility Coverage Broadened: Mandatory coverage for infertility diagnosis and treatment is expanded. This includes required coverage for procedures necessary to screen or diagnose a fertilized egg before implantation, making fertility treatments more accessible.
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Menopause Visits: For individuals aged 45 and older, most insurance plans must now cover an annual menopause health visit without requiring the insured member to meet a cost-sharing requirement (i.e., no co-pay or deductible). Furthermore, coverage for medically necessary hormonal and non-hormonal therapy to treat menopausal symptoms must be provided.
3. Advanced and Diagnostic Imaging
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Breast MRI and MBI Coverage: Coverage for advanced diagnostic imaging, including Molecular Breast Imaging (MBI) or Magnetic Resonance Imaging (MRI) of the breast, must be provided without cost-sharing if a prior mammogram demonstrates heterogeneous or dense breast tissue, or when otherwise medically necessary as determined by a physician. This is a critical step for individuals whose dense tissue masks potential tumors on standard mammograms.
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Colonoscopies: Medically necessary colonoscopies must be covered by group and individual plans, removing a potential financial barrier to vital cancer screening.
4. Related Health Cost Caps
In addition to these mandates, the cost of an Epinephrine Auto-Injector (EpiPen) twin-pack will be capped at $60 (with a $25 individual injector cap for those 18 and under), ensuring emergency allergy medication is affordable.
The Massac County Christmas Light Trail
The centerpiece of our holiday celebrations this month is the Massac County Christmas Light Trail!
What it is: This is a county-wide celebration where local residents and businesses light up their homes and storefronts for all to enjoy. It’s a wonderful way to experience the festive spirit from the warmth of your car.
When to See It: The trail is running every night through December 31st, with participants encouraged to keep their dazzling displays on until at least 9:00 PM each evening.
Find the Map: You can find the official map and the curated festive playlist to enhance your drive by visiting the Massac County Christmas Light Trail Facebook page. There are QR codes and clickable links available there!
Tuesday, December 30, 2025
The Kiwanis Club of Metropolis will not meet today
Wednesday, December 31, 2025
WMOK Community Events Listing
Save The Date
1-1-26, 11-1pm
American Legion (321 Market St.),
Free for all former Allied/Honeywell/DOE workers plus 1 guest
RSVP to Nuclear Care Partners 618-744-0077 by December 29th, 2025
Nuclear Care Partners will be serving a traditional New Year’s Day lunch–buffet style, to serve former Allied/Honeywell workers in the area.
Come to meet the team, mingle with other former atomic workers!
Former Allied/Honeywell workers may be entitled to up to $400,000 in compensation and no-cost medical benefits through the DOL’s EEOICPA.
American Legion Auxiliary #306 PRESENTS-Lucky 7’s
Must Be 18yrs old to enter & play
WMOK's Coffee Break Program:
We invite you to text
questions and topics for our guests to
618-524-9209
Send your Job and Career Listings to WMOK
Text the information to 618-524-9209
Links to Local Employers:
Massac Memorial Hospital
MMH is hiring! Join a team that puts patients first and supports the health of our community every day. Compassion. Excellance. Local Care. Apply today at www.massachealth.org/careers or by scanning the QR code.
Rural Health, Inc.
Metropolis Big John
Shawnee Community College
City of Metropolis
Southern Seven Health Department
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