MedicaidCoverageMedium impact
Increase in Age Limit for Diabetes Prevention and Management Programs Effective November 1, 2024
Illinois Medicaid - HFS·IL · Endocrinology, Family Medicine, General Practice +1 more·Provider Notice
Effective date
Nov 1, 2024
We identified it
Jun 20, 2026
Summary
Illinois Medicaid has eliminated the upper age limit for diabetes prevention and management programs, expanding coverage from ages 18-64 to ages 18 and up for customers who don't qualify for Medicare. This change affects both Medicaid fee-for-service and managed care organizations.
Action Required
Immediately: Billing team must update patient eligibility verification processes to allow diabetes prevention and management program billing for Illinois Medicaid patients age 65 and over who do not qualify for Medicare. Review the updated Billing Guidelines for Diabetes Prevention and Management Programs document and update internal age verification workflows.