MedicaidCoverageLow impact
Over-the-Counter Birth Control
Illinois Medicaid - HFS·IL · Pharmacy, OB-GYN, Family Medicine·Provider Notice
Effective date
Jan 1, 2024
We identified it
Jun 20, 2026
Summary
Illinois Medicaid will cover the new over-the-counter birth control pill Opill without prescription for women 18+ starting early 2024. Pharmacies must submit claims with a prescriber NPI and can use the Illinois Department of Public Health standing order NPI for hormonal contraceptives.
Action Required
Early 2024: If your practice has an in-house pharmacy or works closely with pharmacies, ensure they are aware that Opill claims must include a prescriber NPI in field 411-DB and can use the Illinois Department of Public Health standing order NPI for hormonal contraceptives. Contact 877-782-5565 for FFS claims questions.