Pharmacy
YouthCare is committed to providing appropriate, high-quality, and cost-effective drug therapy to all members. YouthCare covers prescription medications and certain over-the-counter medications with a written order from a YouthCare provider. Other medically necessary pharmacy services are also covered.
However, not all medications are covered, and certain medications may require prior authorization or have limitations.
Current Drug List
- Preferred Drug List (PDF)
- Over the Counter Drug List (PDF)
- YouthCare Prior Authorization Request Form (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.
- Pharmacy Notice 7/30/24 (PDF)
- Pharmacy Notice 6/9/24 (PDF)
- Pharmacy Notice 5/23/24 (PDF)
- Pharmacy Notice 5/3/24 (PDF)
- Pharmacy Notice 4/16/24 (PDF)
- Pharmacy Notice 5/11/23 (PDF)
- Pharmacy Notice 4/26/23 (PDF)
- Pharmacy Notice 3/30/23 (PDF)
- Pharmacy Notice 3/29/23 (PDF)
- Pharmacy Notice 1/18/23 (PDF)
- Pharmacy Notice 1/1/23 (PDF)
- Pharmacy Notice 11/1/22 (PDF)
- Pharmacy Notice 9/29/22 (PDF)
Psychotropic Medication Consent Process
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
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
- Pharmacy Services PA inquiries: 833-491-0418
- DCFS Consent Unit Hotline: 800-828-2179
Provider Disputes
- Disputes for pharmacy claims should be submitted via the Express Scripts® Pharmacist Resource Center
- MAC Appeals Instructions