A new Illinois law will make early eye drop refill protections available through more types of health coverage beginning in 2028.

The change is especially relevant for people with glaucoma and other chronic eye conditions who may run out of prescription drops before their insurance plan normally allows another refill.

Eye drop bottles do not always last as long as expected. Drops can miss the eye, spill, or release more than one drop at a time. These challenges can be more common for people who have difficulty seeing, aiming the bottle, or squeezing it. The American Academy of Ophthalmology notes that medication loss during self-administration can lead to treatment gaps when patients cannot refill their drops promptly.

What Is Changing in Illinois?

Illinois has had an early eye drop refill law since 2016. It generally prevents certain insurers from denying an early refill for a covered topical eye medication when:

• The medication treats a chronic eye condition.
• At least 75% of the expected medication-use period has passed.
• The original prescription permits refills.
• The early refill does not exceed the total number of refills prescribed.

The newly enacted law, Public Act 104-0649, extends those requirements to additional types of Illinois health coverage. These include state employee plans, certain county and municipal employee plans, school employee coverage, health maintenance organizations, limited and voluntary health service plans, and the state’s medical assistance program, which includes Medicaid coverage.

The expanded requirements take effect on January 1, 2028. They do not apply immediately.

The law also does not provide free medication, unlimited refills, or coverage for a drug that is not otherwise covered by the patient’s plan.

Why This Matters for People With Glaucoma

Many people with glaucoma use prescription eye drops regularly to lower eye pressure and help protect their vision. Running out early can create an interruption in treatment.

Patients should not stretch their medication, use fewer drops than prescribed, or stop treatment without speaking with their eye doctor. Instead, they can ask their pharmacist whether an early refill is available and whether additional information is needed from the prescriber.

What About Patients Outside Illinois?

This Illinois law does not apply in other states, but early eye drop refill protections are not limited to Illinois. According to the American Academy of Ophthalmology’s state-by-state information, 32 states had enacted early eye drop refill laws as of April 2026. The details vary, including when an early refill is permitted and which insurance plans are covered.

Regardless of where you live, you can:

• Ask your pharmacist whether your state or insurance plan permits early eye drop refills.
• Make sure your prescription has refills remaining.
• Contact your insurance company when a refill is rejected as “too soon.”
• Ask your eye doctor’s office for help if the pharmacy or insurer needs clarification.
• Avoid changing or stopping your medication without medical guidance.

Learn more in our guide: Running Out of Glaucoma Drops Too Soon? Know Your Early Refill Rights.

The Bigger Picture

Illinois’ new law recognizes a practical reality: Using prescription eye drops is not always perfectly precise, and a bottle may empty sooner than expected.

Although insurance rules vary across the country, patients can take an active role by understanding their refill rights, contacting their pharmacist or insurer early, and asking their eye care team for help before their medication runs out.

Sources: 

• Illinois General Assembly. (Accessed July, 2026). “Public Act 104-0649—”  ilga.gov
• American Academy of Ophthalmology. (Accessed July, 2026). “Early Eyedrop Refills” aao.org

This content from The Glaucoma Community is intended for educational purposes and should not be considered a substitute for professional medical guidance. Please consult with your personal healthcare team prior to adjusting your clinical care. The Glaucoma Community does not recommend or endorse any particular medications, specialists, or commercial products.