Jan. 1, 2023
In 2022, the Illinois Legislature passed a law (House Bill 2595) to make sure Illinois health plans cover medically necessary mental health and drug use care.
Here are some of the ways the law affects Illinois health plans:
- Health plans have to use standard accepted medical practices and treatment methods to decide what’s covered.
- Mental Health and Substance Abuse Treatment will be covered if the care is determined to be “medically necessary”.
- There are no rewards/incentives to doctors or insurance staff to deny or promote any certain type of care.
- Health plans must make information available about how they review member claims and decide what’s approved.
Blue Cross and Blue Shield of Illinois (BCBSIL) health plans cover mental health and drug use treatment. Providing access to quality, cost-effective and equitable health care in the communities we serve remains at the heart of what we do.
We will be giving more details about how we look at member claims and approve benefits and services in the coming weeks.
To learn more about the process to review claims and what benefits are covered, BCBSIL members can: