MedicaidCoverageLow impact
Co-payments for Illinois Cares Rx
Illinois Medicaid - HFS·IL · Pharmacy·Provider Notice
Effective date
Jan 10, 2006
We identified it
Jun 21, 2026
Summary
Illinois Cares Rx program updated co-payment structure for prescription drugs with Generic $2, Brand $5, and Non-Preferred $15 tiers. The program replaced hard prior approval edits with tiered co-payments to give patients more flexibility in drug choices.
Action Required
No action required for medical billing teams. This is a pharmacy-specific policy change affecting prescription drug co-payments only, not medical services billing.