MedicaidCoverageMedium impact
Illinois Healthy Women Program (Family Planning Waiver) Expansion
Illinois Medicaid - HFS·IL · OB-GYN, Family Medicine, General Practice·Provider Notice
Effective date
Dec 4, 2007
We identified it
Jun 21, 2026
Summary
Illinois expanded the Healthy Women Program (IHW) to allow direct applications for family planning coverage for women ages 19-44. The program covers family planning services with V25 diagnosis codes, requires prior authorization for STI medications and multivitamins, and has no co-payments for most family planning services.
Action Required
Immediately: Billing team must update Illinois Medicaid billing procedures to recognize IHW coverage for family planning services using V25 diagnosis codes. Configure system to require prior authorization for STI medications and multivitamins (call 1-800-252-8942). Update encounter forms to remind providers that prenatal vitamins do not require prior auth but multivitamins do. Ensure no co-payments are applied to generic family planning medications.