MedicaidCoverageMedium impact
Coverage of Preventive Services for Adults Age 19-64
Illinois Medicaid - HFS·IL · Family Medicine, Internal Medicine, General Practice +1 more·Provider Notice
Effective date
Jan 1, 2015
We identified it
Jun 20, 2026
Summary
Illinois Medicaid will cover preventive services for adults age 19-64 without cost sharing when visits are preventive in nature, limited to two visits per year. Two new medications (aspirin and folic acid tablets) will be covered without cost sharing when prescribed per USPSTF guidelines.
Action Required
By January 1, 2015: Billing team must ensure preventive services for adults 19-64 are coded with appropriate preventive medicine E&M codes and proper diagnosis codes to receive 100% coverage. Update billing system to recognize aspirin and folic acid prescriptions per USPSTF guidelines as covered without cost sharing. Train staff that cost sharing applies when preventive services are part of problem-focused visits.