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Preferred Drug List Illinois Medicaid July 1, 2014 Changes are highlighted in blue and marked with an asterisk (*) ***For drugs not found on this list, go to the drug search engine at: http:/ilpriorauth.com/.

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Related content

Drug Prior Approval Information - Illinois.gov
Some prescriptions and over-the-counter medicines require prior authorization for Medicaid...
Learn more
Drug Search
Home · HFS Home · JB Pritzker, Governor. GENERAL INFORMATION. Preferred Drug List (PDL)...
Learn more
Instructions for Form 7004 (Rev. December 2017)...
Feb 1, 2018 — Illinois, Kentucky, Michigan, Tennessee, and Wisconsin. See. Where To File...
Learn more

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Professional dispensing fee is: $13.20 for claims less than 90,000. $10.05 for claims 90,000 or more.

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).

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© Copyright 1997-2025
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232