MedicaidAdministrativeMedium impact
Change in Prescription Drug Coverage for Beneficiaries in Voluntary Medicaid Managed Care Plans
Illinois Medicaid - HFS·IL · Pharmacy·Provider Notice
Effective date
Apr 1, 2013
We identified it
Jun 20, 2026
Summary
Effective April 1, 2013, prescription drug coverage for Medicaid managed care plan beneficiaries in Illinois is no longer carved out - the managed care plans are now directly responsible for pharmacy benefits instead of fee-for-service Medicaid. Pharmacy questions should be directed to the specific managed care plan (Family Health Network, Harmony Health Plan, or Meridian Health Plan) rather than state Medicaid.
Action Required
Immediately: Update pharmacy billing processes to submit prescription claims directly to Medicaid managed care plans instead of state Medicaid fee-for-service. Verify beneficiary enrollment and contact appropriate plan for pharmacy benefit questions: Family Health Network (1-888-346-4968), Harmony Health Plan (1-800-608-8158), or Meridian Health Plan (1-866-606-3700).