MedicaidCoverageMedium impact
Arexvy RSV Vaccine
Illinois Medicaid - HFS·IL · Family Medicine, Internal Medicine, Geriatrics +1 more·Provider Notice
Effective date
Dec 8, 2023
We identified it
Jun 20, 2026
Summary
Illinois Medicaid now covers Arexvy RSV vaccine for patients aged 60 and over through both pharmacy point-of-sale and medical billing without prior authorization requirements. This expands coverage options for RSV vaccination in eligible Medicaid beneficiaries.
Action Required
Immediately: Update billing procedures to include Arexvy RSV vaccine coverage for Illinois Medicaid patients aged 60+. Verify patient eligibility and bill through either pharmacy point-of-sale or medical billing without obtaining prior authorization. Contact pharmacy consultant at 877-782-5565 for FFS claims questions or appropriate MCO for managed care questions.