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To get answers to your questions, call YouthCare at 844-289-2264 or email ILYouthCare@centene.com
To get answers to your questions, call YouthCare at 844-289-2264 or email ILYouthCare@centene.com

Pharmacy Services

Ensuring Access to Safe and Effective Medications

At YouthCare, we are committed to providing appropriate, high-quality, and cost-effective drug therapy to all our members. With our partners, we provide innovative and tailored pharmacy solutions, improving member health outcomes by ensuring access to essential medications, cost effective treatments and personalized clinical programs.

YouthCare offers clinical programs that are customized to drive medication adherence and reduce medication errors. These programs are designed to improve health outcomes by supporting members in managing chronic conditions and ensuring they receive the right medications at the right time to get and stay healthy.

Our pharmacy program uses a large pharmacy network to give members access to many types of pharmacies, including retail, mail-order, and specialty pharmacies. This makes it easy for members to get their medications. We work closely with our pharmacy programs to make sure the needs of our YouthCare members are met.

YouthCare covers certain prescription drugs and over-the-counter drugs when prescribed by a YouthCare provider. The Preferred Drug List (PDL) is the list of drugs covered by YouthCare and is based on the IL Department of Health and Family Services Preferred Drug List. The PDL does not cover all drugs. Some require prior authorization. Some drugs have limitations on age, dosage, or maximum quantities. YouthCare asks that doctors prescribe medications from the YouthCare PDL. If a medication is not on the PDL, the provider may need to submit a prior approval request before the member can receive it at the pharmacy. These drugs are listed on the prior approval list.

Preferred Drug List (PDF)

To prescribe a drug that requires prior authorization and/or a drug that is not on the preferred drug list, providers can submit a request using covermymeds or complete a Medication Prior Authorization Request Form (PDF). Forms can be faxed to 844-205-3384. In emergency situations, call 833-491-0418.

Specialty Pharmacy Services

Through our specialty pharmacy services, we offer support for high-cost medications and complex therapies, ensuring members have access to the treatments they need with the guidance of a dedicated pharmacy team.

DCFS Rule and Procedure 325 requires psychotropic medications consent for children in the care of DCFS.

An efficient system for psychotropic medication consent has been created

  • Pay claims at the point of sale only when consent is on file with YouthCare HealthChoice and DCFS
  • Provide customized reject messaging to pharmacists informing them of consent and/or prior authorization requirements
  • All non-psychotropic medications are reviewed via the standard review process
  • Prior authorizations received for psychotropic medications are returned to provider with consent information

YouthCare receives files throughout the day from DCFS consultants containing approved and denied consents

pharmacy flow chard

Separate YouthCare prior authorization is not required

Please submit electronic Form CFS 431-A using the DCFS Guardian Consent Portal or Psychotropic Medication Request Form (CFS 431-A) (PDF) should be faxed to (312) 814-7015.

YouthCare’s Pharmacy Services PA department is equipped to provide 24/7 pharmacy support. The call center can:

  • Provide help with claims processing issues
  • Triage calls to YouthCare as appropriate

Contacts

Provider Disputes

  • Disputes for pharmacy claims should be submitted via the Express Scripts® Pharmacist Resource Center
  • MAC Appeals Instructions