Traditional MedicareCoverageHigh impact
Medicare Part D and Changes to Medicaid, SeniorCare and Circuit Breaker Pharmaceutical Assistance
Illinois Medicaid - HFS·IL · Pharmacy·Provider Notice
Effective date
Jan 1, 2006
We identified it
Jun 21, 2026
Summary
Medicare Part D launches January 1, 2006, transitioning dual-eligible clients from Medicaid pharmacy benefits to Medicare prescription drug plans. SeniorCare and Circuit Breaker programs merge into Illinois Cares Rx with wrap-around benefits for Medicare gaps.
Action Required
By January 1, 2006: Pharmacy staff must verify dual-eligible patients have Medicare Part D enrollment and bill Medicare PDPs first, then Illinois Cares Rx for wrap-around benefits. Update billing system to recognize new Illinois Cares Rx cards with processor control numbers ISC47865 (Medicare-eligible) and ISC47875 (non-Medicare). Train staff to identify coordinating PDPs (AARP MedicareRx Plan S5820/016 and PacifiCare Saver Plan S5921/082) for wrap-around benefits.