Sept. 26, 2024
Effective Jan. 1, 2025, some of our commercial member benefit plans will include coverage for vaginal estrogen medication as mandated by Illinois State House Bill 1565.
Under this benefit expansion, member cost sharing for vaginal estrogen cream will be at the same level as cost sharing for covered prescription erectile dysfunction medications.
What do you need to do? Prescriptions for these medications must be filled at an in-network pharmacy to qualify for the cost sharing requirement.
This applies to FDA-approved vaginal estrogen or its therapeutic equivalent.
This is for informational and educational purposes only and is not a substitute for the independent medical judgment of a physician or other health care provider, nor is the information presented intended to replace or supersede any requirements set forth in your contract with Blue Cross and Blue Shield of Illinois. Physicians and other health care providers should use their own medical judgment based upon all available information and the condition of the patient in determining the appropriate course of treatment.