MedicaidCoverageMedium impact
Confirmation of No Copayment for Naloxone Effective January 1, 2023, per Public Act 102-1038
Illinois Medicaid - HFS·IL · Pharmacy, Family Medicine, Internal Medicine +1 more·Provider Notice
Effective date
Jan 1, 2023
We identified it
Jun 20, 2026
Summary
Effective January 1, 2023, Illinois Medicaid will not charge patient copayments for Naloxone (opioid overdose reversal medication) under both fee-for-service and managed care plans. Pharmacies dispensing Naloxone should not collect drug copayments from Illinois Medicaid patients.
Action Required
Immediately: Billing team must verify that pharmacy billing systems do not charge copayments for Naloxone prescriptions for Illinois Medicaid patients under both fee-for-service and managed care plans. Update patient collection procedures to reflect zero copayment for this medication. Contact Bureau of Professional and Ancillary Services at 877-782-5565 for FFS claims questions or applicable MCO plan for managed care questions.