Get Ilpriorauth

When pharmacists fill a prescription, they charge what is known as a dispensing fee to cover costs of storing and preparing medication, as well as providing services to clients. These fees can vary from pharmacy to pharmacy, and can be a significant cost for patients.

The Illinois Medicaid program covers all prescription drugs, as well as some over-the-counter (OTC) products, made by manufacturers that have a signed rebate agreement with the federal Centers for Medicare and Medicaid Services (CMS).

Your pharmacy will charge a dispensing fee per prescription. Hence, if you have three prescriptions and the pharmacy has a $10 dispensing fee, the total amount you would pay for dispensing fees would be $30. This is not the total cost of your prescription.

Prime Therapeutics is the Pharmacy Benefit Manager (PBM) that provides drug benefits through Blue Cross and Blue Shield of Illinois (BCBSIL). Providers can access, complete, and submit prior authorization requests using the uniform PA form.

Inpatient Facility Admission Summary Elective admissions must have prior authorization before the admission occurs. All unplanned inpatient hospital care (surgical, non-surgical, behavioral health and/or substance abuse). Notification must be made within one business day of admission to the facility.

The dispensing fee is intended to cover reasonable costs associated with providing the drug to a Medicaid beneficiary. This cost includes the pharmacist's services and the overhead associated with maintaining the facility and equipment necessary to operate the pharmacy.

The Illinois Medicaid program covers all prescription drugs, as well as some over-the-counter (OTC) products, made by manufacturers that have a signed rebate agreement with the federal Centers for Medicare and Medicaid Services (CMS).