Preferred Drug List (PDL) Updates
2025 Illinois YouthCare Preferred Drug List Updates
This is an update to the YouthCare HealthChoice Illinois (YouthCare) Preferred Drug List.
Coverage of the medications listed below has changed, effective [9/01/2025], for all members. Please reference the table for changes.
Note: Active prior authorizations for the medication(s) listed will not be affected.
For questions, please call YouthCare Provider Services at 844-289-2264.
| Impacted Medication | Change | Preferred Agents or New Limits |
|---|---|---|
| All Specialty Medication | Revised medication refill guidelines | A balance-on-hand edit will be applied to prescription refills. Members may receive early refills totaling up to 18 days within a rolling six-month period. |
This is an update to the YouthCare HealthChoice Illinois (YouthCare) Preferred Drug List.
Coverage of the medications listed below has changed, effective [7/15/2025], for all members. Please reference the table for changes.
Note: Active prior authorizations for the medication(s) listed will not be affected.
For questions, please call YouthCare Provider Services at 844-289-2264.
| Impacted Medication | Change | Preferred Agents or New Limits |
|---|---|---|
| CEFPODOXIME Tablet and suspension | Coverage | Preferred |
| LYBALVI Tablet | Coverage | Preferred |
| NGENLA | Coverage | Preferred with Prior Auth. Product (NDC) specific |
| SKYTROFA | Coverage | Preferred with Prior Auth. Product (NDC) specific |
This is an update to the YouthCare HealthChoice Illinois (YouthCare) Preferred Drug List.
Coverage of the medications listed below has changed, effective [10/01/2025], for all members. Please reference the table for changes.
Note: Active prior authorizations for the medication(s) listed will not be affected.
For questions, please call YouthCare Provider Services at 844-289-2264.
| Impacted Medication | Change | Preferred Agents or New Limits |
|---|---|---|
| All Alcohol Swabs | New Limit | Alcohol Swabs are limited to $20 per claim |
| All Lancets | New Limit | Lancets are limited to $40 per claim |
This is an update to the YouthCare HealthChoice Illinois (YouthCare) Preferred Drug List..
Coverage of the medications listed below will change, effective [08/18/2025], for all members. Please reference the table for changes.
Note: Active prior authorizations for the medication(s) listed will not be affected.
For questions, please call YouthCare Provider Services at 844-289-2264.
| Impacted Medication | Change | Preferred Agents |
|---|---|---|
| Cetirizine chewable | Non-formulary | Cetirizine Solution |
This is an update to the YouthCare HealthChoice Illinois (YouthCare) Preferred Drug List..
Coverage of the medications listed below will change, effective [06/01/2025], for all members. Please reference the table for changes.
For questions, please call YouthCare Provider Services at 844-289-2264.
| Impacted Medication | Change | Preferred Agents/New Limits |
|---|---|---|
| LYBALVI | Coverage | Preferred |
| ATOMOXETINE | Coverage | Preferred |
This is an update to the YouthCare HealthChoice Illinois (YouthCare) Preferred Drug List..
Coverage of the medications listed below has changed for all members. Please reference the table for changes.
For questions, please call YouthCare Provider Services at 844-289-2264.
| Impacted Medication | Change | Preferred Agents/New Limits |
|---|---|---|
| INSULIN ASPA INJ 100/ML | New PDL Status | Preferred as of 03/28/25 |
| INSULIN ASPA INJ FLEXPEN | New PDL Status | Preferred as of 03/28/25 |
| INSULIN ASPA INJ PENFILL | New PDL Status | Preferred as of 03/28/25 |
| INSULIN LISP INJ 100/ML | New PDL Status | Preferred as of 03/28/25 |
| INSULIN LISP INJ JUNIOR | New PDL Status | Preferred as of 03/28/25 |
| INSULIN LISP INJ 100/ML | New PDL Status | Preferred as of 03/28/25 |
| HUMALOG INJ 100/ML | New PDL Status | Non-Preferred as of 06/30/25 |
| HUMALOG JR INJ 100/ML | New PDL Status | Non-Preferred as of 06/30/25 |
| HUMALOG KWIK INJ 100/ML | New PDL Status | Non-Preferred as of 06/30/25 |
This is an update to the YouthCare HealthChoice Illinois (YouthCare) Preferred Drug List..
Coverage of the medications listed below has changed, effective March 27, 2025, for all members. Please reference the table for changes.
For questions, please call YouthCare Provider Services at 844-289-2264.
| Impacted Medication | Preferred/Non-Preferred | Comments/Preferred Agents |
|---|---|---|
| PERMETHRIN | Non-Preferred | Product No longer Preferred as of 06/30/25 |
| SIKLOS | Preferred | Changing to Preferred for children aged 2-17 |
| GLATOPA | Preferred | Changing to Preferred from Non-Preferred |
| MYRBETRIQ | Preferred | Changing to Preferred from Non-Preferred |
| CARBAGLU | Preferred with PA | Changing to Preferred with PA from Non-Preferred |
| REZDIFFRA | Preferred with PA | Changing to Preferred with PA from Non-Preferred |
This is an update to the YouthCare HealthChoice Illinois (YouthCare) Preferred Drug List..
Coverage of the medications listed below has changed, effective June 30, 2025, for all members. Please reference the table for changes.
For questions, please call YouthCare Provider Services at 844-289-2264.
| Impacted Medication | Preferred/Non-Preferred | Comments/Preferred Agents |
|---|---|---|
| HUMIRA | Non-Preferred | For the following indications submit PA for brand; Pediatric hidradenitis suppurativa (HS; Ages 12-17), Pediatric UC (Ages 5-17), Pediatric uveitis (UV Ages 2-17), ALL OTHERS - Use SIMLANDI or ADALIMUMAB-ADBM (generic for CYLTEZO) |
| HUMIRA PEN | Non-Preferred | For the following indications submit PA for brand; Pediatric hidradenitis suppurativa (HS; Ages 12-17), Pediatric UC (Ages 5-17), Pediatric uveitis (UV Ages 2-17), ALL OTHERS - Use SIMLANDI or ADALIMUMAB-ADBM (generic for CYLTEZO) |
| HUMIRA PEN-CD/UC/HS START | Non-Preferred | For the following indications submit PA for brand; Pediatric hidradenitis suppurativa (HS; Ages 12-17), Pediatric UC (Ages 5-17), Pediatric uveitis (UV Ages 2-17), ALL OTHERS - Use SIMLANDI or ADALIMUMAB-ADBM (generic for CYLTEZO) |
| HUMIRA PEN-PEDIATRIC UC STARTER PACK | Non-Preferred | For the following indications submit PA for brand; Pediatric hidradenitis suppurativa (HS; Ages 12-17), Pediatric UC (Ages 5-17), Pediatric uveitis (UV Ages 2-17), ALL OTHERS - Use SIMLANDI or ADALIMUMAB-ADBM (generic for CYLTEZO) |
| HUMIRA PEN-PS/UV STARTER | Non-Preferred | For the following indications submit PA for brand; Pediatric hidradenitis suppurativa (HS; Ages 12-17), Pediatric UC (Ages 5-17), Pediatric uveitis (UV Ages 2-17), ALL OTHERS - Use SIMLANDI or ADALIMUMAB-ADBM (generic for CYLTEZO) |
| SIMLANDI | Preferred with PA | Changing to Preferred with PA as of 03/27/25 |
| SIMLANDI 1-PEN KIT | Preferred with PA | Changing to Preferred with PA as of 03/27/25 |
| SIMLANDI 2-PEN KIT | Preferred with PA | Changing to Preferred with PA as of 03/27/25 |
| ADALIMUMAB-ADBM | Preferred with PA | Changing to Preferred with PA as of 03/27/25 |
| ADALIMUMAB-ADBM STARTER P | Preferred with PA | Changing to Preferred with PA as of 03/27/25 |
This is an update to the YouthCare HealthChoice Illinois (YouthCare) Preferred Drug List..
Coverage of the medications listed below has changed, effective June 30, 2025, for all members. Please reference the table for changes.
For questions, please call YouthCare Provider Services at 844-289-2264.
| Impacted Medication | Preferred/Non-Preferred | Stipulations/Comments |
|---|---|---|
| INSULIN DEGLUDEC | Preferred | Moved from NON-Preferred to Preferred |
| INSULIN DEGLUDEC FLEXTOUC H | Preferred | Moved from NON-Preferred to Preferred |
| GLUCAGEN HYPOKIT | Preferred | Moved from NON-Preferred to Preferred |
| GLUCAGON EMERGENCY KIT FOR LOW BLOOD SUGAR | Preferred | Moved from NON-Preferred to Preferred |
| BAQSIMI ONE PACK | Preferred | Moved from NON-Preferred to Preferred |
| BAQSIMI TWO PACK | Preferred | Moved from NON-Preferred to Preferred |
This is an update to the YouthCare HealthChoice Illinois (YouthCare) Preferred Drug List..
Coverage of the medications listed below has changed, effective June 30, 2025, for all members. Please reference the table for changes.
For questions, please call YouthCare Provider Services at 844-289-2264.
| Impacted Medication | Preferred/Non-Preferred | Stipulations/Comments |
|---|---|---|
| CEQUR SIMPLICITY 2U | Preferred with PA | NDC Specific 73108000008 |
| CEQUR SIMPLICITY INSERTER | Preferred with PA | NDC Specific 73108000008 |
| CONTOUR PLUS BLOOD GLUCOSE MONITORING SYSTEM | Preferred Product | Moved to Preferred as of 03/27/25 NDC Specific – 00193703601 |
| CONTOUR PLUS BLOOD GLUCOSE TEST STRIPS | Preferred Product | Moved to Preferred as of 03/27/25 NDC Specific – 00193758450 |
| DEXCOM G6 RECEIVER | Non-Preferred NDC | Product remains Preferred with PA, however NDCs below is NON-Preferred 50090636500 |
| DEXCOM G6 SENSOR | Non-Preferred NDC | Product remains Preferred with PA, however NDCs below is NON-Preferred 50090636400 |
| DEXCOM G6 TRANSMITTER | Non-Preferred NDC | Product remains Preferred with PA, however NDCs below is NON-Preferred 50090636600 |
| DEXCOM G7 RECEIVER | Non-Preferred NDC | Product remains Preferred with PA, however NDCs below is NON-Preferred 50090642900 |
| DEXCOM G7 SENSOR | Non-Preferred NDC | Product remains Preferred with PA, however NDCs below is NON-Preferred 50090643000 |
| FREESTYLE LIBRE 2/READER/FLASH GLUCOSE MONITORING SYSTEM | Non-Preferred NDC | Product remains Preferred with PA, however NDCs below is NON-Preferred 50090629200 |
| FREESTYLE LIBRE 2/SENSOR/FLASH GLUCOSE MONITORING SYSTEM | Non-Preferred NDC | Product remains Preferred with PA, however NDCs below is NON-Preferred 50090629000 |
| FREESTYLE LIBRE 3 PLUS/SENSOR/GLUCOSE MONITORING SYSTEM | Non-Preferred NDC | Product remains Preferred with PA, however NDCs below is NON-Preferred 50090724800 |
| FREESTYLE LIBRE 3/READER/GLUCOSE MONITORING SYSTEM | Non-Preferred NDC | Product remains Preferred with PA, however NDCs below is NON-Preferred 50090710000 |
| FREESTYLE LIBRE 3/SENSOR/GLUCOSE MONITORING SYSTEM | Non-Preferred NDC | Product remains Preferred with PA, however NDCs below is NON-Preferred 50090638500 |
| FREESTYLE LIBRE/READER/FLASH MONITORING SYSTEM | Non-Preferred NDC | Product remains Preferred with PA, however NDCs below is NON-Preferred 57599000021 |
| GUARDIAN 4 GLUCOSE SENSOR | Preferred with PA | Moved from Non-Preferred to Preferred with PA as of 03/27/25 |
| GUARDIAN 4 TRANSMITTER KIT | Preferred with PA | Moved from Non-Preferred to Preferred with PA as of 03/27/25 |
| GUARDIAN CONNECT TRANSMITTER | Preferred with PA | Moved from Non-Preferred to Preferred with PA as of 03/27/25 |
| GUARDIAN CONNECT TRANSMITTER KIT | Preferred with PA | Moved from Non-Preferred to Preferred with PA as of 03/27/25 |
| GUARDIAN LINK 3 TRANSMITTER KIT | Preferred with PA | Moved from Non-Preferred to Preferred with PA as of 03/27/25 |
| GUARDIAN SENSOR (3) | Preferred with PA | Moved from Non-Preferred to Preferred with PA as of 03/27/25 |
| GUARDIAN SENSOR 3 | Preferred with PA | Moved from Non-Preferred to Preferred with PA as of 03/27/25 |
| ILET INSULIN INFUSION KIT MIS 23 | Preferred with PA | Preferred with PA as of 03/27/25 |
| ILET INSULIN INFUSION KIT MIS32 | Preferred with PA | Preferred with PA as of 03/27/25 |
| ILET INSULIN PUMP MIS PUMP | Preferred with PA | Preferred with PA as of 03/27/25 |
| ILET STARTER KIT- INSET MIS 32 | Preferred with PA | Preferred with PA as of 03/27/25 |
| ILET STARTER KIT- INSET MIS23 | Preferred with PA | Preferred with PA as of 03/27/25 |
| ILET STARTER KIT-CONTAC MIS CONTACT | Preferred with PA | Preferred with PA as of 03/27/25 |
| OMNIPOD 5 DEXCOM G7G6 INTRO KIT (GEN 5) | Non-Preferred NDC | Product remains Preferred with PA, however NDCs below is NON-Preferred 08508300075 |
| OMNIPOD 5 DEXCOM G7G6 PODS (GEN 5) | Non-Preferred NDC | Product remains Preferred with PA, however NDCs below is NON-Preferred 08508300021 |
| OMNIPOD 5 DEXCOM G7G6 PODS (GEN 5) | Non-Preferred NDC | Product remains Preferred with PA, however NDCs below is NON-Preferred 08508300075 |
| OMNIPOD 5 G7 INTRO KIT (GEN 5) | Non-Preferred NDC | Product remains Preferred with PA, however NDCs below is NON-Preferred 08508300050 |
| OMNIPOD 5 G7 PODS (GEN 5) | Non-Preferred NDC | Product remains Preferred with PA, however NDCs below is NON-Preferred 08508300053 |
| OMNIPOD 5 LIBRE2 PLUS G6 | Non-Preferred NDC | Product remains Preferred with PA, however NDCs below is NON-Preferred 08508300088 |
| OMNIPOD CLASSIC PDM STARTER KIT (GEN 3) | Non-Preferred NDC | Product remains Preferred with PA, however NDCs below is NON-Preferred 08508114002 |
| OMNIPOD CLASSIC PODS (GEN 3) | Non-Preferred NDC | Product remains Preferred with PA, however NDCs below is NON-Preferred 08508112005 |
| OMNIPOD DASH INTRO KIT (GEN 4) | Non-Preferred NDC | Product remains Preferred with PA, however NDCs below is NON-Preferred 08508200032 |
| OMNIPOD DASH PDM KIT (GEN 4) | Non-Preferred NDC | Product remains Preferred with PA, however NDCs below is NON-Preferred 08508200000 |
| ONETOUCH ULTRA 2 | Non-Preferred Product | Changing to Non-Preferrred: USE CONTOUR PLUS BLOOD GLUCOSE MONITORING SYSTEM |
| ONETOUCH ULTRA BLUE TESTSTRIP | Non-Preferred Product | Changing to Non-Preferrred: USE CONTOUR PLUS BLOOD GLUCOSE MONITORING SYSTEM |
| ONETOUCH ULTRA Test Strips | Non-Preferred Product | Changing to Non-Preferrred: USE CONTOUR PLUS BLOOD GLUCOSE MONITORING SYSTEM |
| ONETOUCH VERIO FLEX BLOOD GLUCOSE MONITORING SYSTEM | Non-Preferred Product | Changing to Non-Preferrred: USE CONTOUR PLUS BLOOD GLUCOSE MONITORING SYSTEM |
| ONETOUCH VERIO TEST STRIPS | Non-Preferred Product | Changing to Non-Preferrred: USE CONTOUR PLUS BLOOD GLUCOSE MONITORING SYSTEM |
This is an update to the YouthCare HealthChoice Illinois (YouthCare) Preferred Drug List..
Coverage of the medications listed below has changed, effective March 27, 2025, for all members. Please reference the table for changes.
For questions, please call YouthCare Provider Services at 844-289-2264.
| Impacted Medication | Change | Comments/Preferred Agents |
|---|---|---|
| CAPLYTA | Preferred | Moved from Non-Preferred to Preferred |
| VRAYLAR | Preferred | Moved from Non-Preferred to Preferred |
| REXULTI | Preferred | Moved from Non-Preferred to Preferred |
| ZURZUVAE | Preferred | Moved from Non-Preferred to Preferred |
This is an update to the YouthCare HealthChoice Illinois (YouthCare) Preferred Drug List..
Coverage of the medications listed below has changed, effective June 30, 2025, for all members. Please reference the table for changes.
For questions, please call YouthCare Provider Services at 844-289-2264.
| Impacted Medication | Change | Comments/Preferred Agents |
|---|---|---|
| INVIRASE | Non-Preferred | Changed from Non-Preferred to Preferred |
| STAVUDINE | Non-Preferred | Changed from Non-Preferred to Preferred |
| DIDANOSINE | Non-Preferred | Changed from Non-Preferred to Preferred |
| RUKOBIA | Preferred | Changed to Preferred as of 03/27/25 |
| CABENUVA | Preferred | Changed to Preferred as of 03/27/25 |
| JULUCA | Preferred | Changed to Preferred as of 03/27/25 |
| PIFELTRO | Preferred | Changed to Preferred as of 03/27/25 |
| PREZCOBIX | Preferred | Changed to Preferred as of 03/27/25 |
| MARAVIROC | Preferred | Changed to Preferred as of 03/27/25 |
| SELZENTRY | Preferred | Changed to Preferred as of 03/27/25 |
This is an update to the YouthCare HealthChoice Illinois (YouthCare) Preferred Drug List..
Coverage of the medications listed below has changed, effective March 27, 2025, for all members. Please reference the table for changes.
For questions, please call YouthCare Provider Services at 844-289-2264.
| Impacted Medication | Change | Comments/Preferred Agents |
|---|---|---|
| AIRSUPRA | Preferred | Changed from Non-Preferred to Preferred |
| ARNUITY ELLIPTA | Preferred | Changed from Non-Preferred to Preferred |
| FLUTICASONE PROPIONATE DISKUS | Preferred | Changed from Non-Preferred to Preferred |
| PROAIR DIGIHALER | Preferred | Changed from Non-Preferred to Preferred |
| PULMICORT FLEXHALER | Preferred | Changed from Non-Preferred to Preferred |
| CINQAIR | Preferred with PA | Changed from Non-Preferred to Preferred with PA |
| TEZSPIRE | Preferred with PA | Changed from Non-Preferred to Preferred with PA |
This is an update to the YouthCare HealthChoice Illinois (YouthCare) Preferred Drug List..
Coverage of the medications listed below has changed, effective April 15, 2025, for all members. Please reference the table for changes.
Note: Active prior authorizations for the medication(s) listed will not be affected.
For questions, please call YouthCare Provider Services at 844-289-2264.
| Impacted Medication | Change | Preferred Agents or New Limits |
|---|---|---|
| Blood Pressure Monitors | Coverage Change | Not Covered under Pharmacy Benefit, must use Medical Benefit. |
This is an update to the YouthCare HealthChoice Illinois (YouthCare) Preferred Drug List..
Coverage of the medications listed below has changed, effective January 1, 2025, for all members. Please reference the table for changes.
Note: Active prior authorizations for the medication(s) listed will not be affected.
For questions, please call YouthCare Provider Services at 844-289-2264.
| Impacted Medication | Change | Preferred Agents or New Limits |
|---|---|---|
| FT EARLY RESULT PREGNANCY NDC 10939095990 | Coverage | Preferred |
| CLEARBLUE PLUS PREGNANCY NDC 33472032258 | Coverage | Preferred |
| PREGNANCY TEST NDC 96295014152 | Coverage | Preferred |
This is an update to the YouthCare HealthChoice Illinois (YouthCare) Preferred Drug List..
Coverage of the medications listed below has changed, effective April 1, 2025, for all members. Please reference the table for changes.
Note: Active prior authorizations for the medication(s) listed will not be affected.
For questions, please call YouthCare Provider Services at 844-289-2264.
| Impacted Medication | Change | Preferred Agents or New Limits |
|---|---|---|
| Liraglutide Soln Pen-injector 18 MG/3ML (6 MG/ML) | New Limit | 0.3 ml daily |
2024 Illinois YouthCare Preferred Drug List Updates
This is an update to the YouthCare HealthChoice Illinois (YouthCare) Preferred Drug List..
Coverage of the medications listed below has changed, effective November 1, 2024, for all members. Please reference the table for changes.
Note: Active prior authorizations for the medication(s) listed will not be affected.
For questions, please call YouthCare Provider Services at 844-289-2264.
| Impacted Medication | Change | Preferred Agents or New Limits |
|---|---|---|
| ENDARI POW 5GM | Coverage | Preferred |
| VICTOZA INJ 18MG/3ML | Coverage | Preferred |
| LIRAGLUTIDE INJ 18MG/3ML | Coverage | Preferred |
| MYRBETRIQ TAB 25MG and 50 mg | Coverage | Non-preferred |
| MIRABEGRON TAB 25MG ER and 50 MG ER | Coverage | Preferred |
| MYRBETRIQ SUS 8MG/ML | Coverage | Non-preferred |
| EMFLAZA TAB 6MG, 18 MG, 30 MG, 36 MG | Coverage | Non-preferred |
| DEFLAZACORT TAB 6MG, 18 MG, 30 MG, 36 MG | Coverage | Non-preferred |
| EMFLAZA SUS 22.75/ML | Coverage | Non-preferred |
| DEFLAZACORT SUS 22.75MG | Coverage | Non-preferred |
This is an update to the YouthCare HealthChoice Illinois (YouthCare) Preferred Drug List..
Coverage of the medications listed below has changed, effective February 1, 2025, for all members. Please reference the table for changes.
Note: Active prior authorizations for the medication(s) listed will not be affected.
For questions, please call YouthCare Provider Services at 844-289-2264.
| Impacted Medication | Change | Preferred Agents or New Limits |
|---|---|---|
| L-GLUTAMINE POW 5GM | Coverage | Non-preferred |
This is an update to the YouthCare HealthChoice Illinois (YouthCare) Preferred Drug List.
Coverage of the medications listed below has changed, effective December 1, 2024, for all members. Please reference the table for changes.
Note: Active prior authorizations for the medication(s) listed will not be affected.
If you have any questions, please call the pharmacy help desk at 844-289-2264.
| Impacted Medication | Change | Preferred Agents or New Limits |
|---|---|---|
| AMLADEX TAB | Coverage Change | Removed from Preferred Drug list |
This is an update to the YouthCare HealthChoice Illinois (YouthCare) Preferred Drug List.
Coverage of the medications listed below has changed, effective December 1, 2024, for all members. Please reference the table for changes.
Note: Active prior authorizations for the medication(s) listed will not be affected.
If you have any questions, please call the pharmacy help desk at 844-289-2264.
| Impacted Medication | Change | Preferred Agents or New Limits |
|---|---|---|
| DERMACINRX FOLIFLEX CAPLET | Coverage Change | Removed from Preferred Drug list |
| DERMACINRX VITRAMYN CAPLET | Coverage Change | Removed from Preferred Drug list |
| DERMACINRX VITRANOL CAPLET | Coverage Change | Removed from Preferred Drug list |
| DERMACINRX VITREXATE CAPLET | Coverage Change | Removed from Preferred Drug list |
| DEKAS PLUS SOFTGEL | Coverage Change | Removed from Preferred Drug list |
| All Multivitamins and Vitamins | New Limits | Vitamins are limited to $300 per claim Multivitamins are limited to $450 per claim |
This is an update to the YouthCare HealthChoice Illinois (YouthCare) Preferred Drug List.
Coverage of the medications listed below will change, effective August 1, 2024, for all members. Please reference the table for changes.
Note: Active prior authorizations for the medication(s) listed will not be affected.
For questions, please call YouthCare Provider Services at 844-289-2264.
Impacted Medication | Change | Preferred Agents or New Limits |
|---|---|---|
Trulicity | Coverage Change | Preferred with Diabetes Diagnosis; all other diagnosis submit Prior Authorization |
Victoza | Coverage Change | Preferred with Diabetes Diagnosis; all other diagnosis submit Prior Authorization |
This is an update to the YouthCare HealthChoice Illinois (YouthCare) Preferred Drug List.
Coverage of the medications listed below will change, effective September 17, 2024, for all members. Please reference the table for changes.
Note: Active prior authorizations for the medication(s) listed will not be affected.
For questions, please call YouthCare Provider Services at 844-289-2264
Impacted Medication | Change | New Limit |
|---|---|---|
Trulicity Soln Pen-injector 0.75 MG/0.5ML | New limits | Restricted to one medication (GLP-1 receptor agonists) per month |
This is an update to the YouthCare HealthChoice Illinois (YouthCare) Preferred Drug List.
Coverage of the medications listed below will change, effective August 15, 2024, for all members. Please reference the table for changes.
Note: Active prior authorizations for the medication(s) listed will not be affected.
For questions, please call YouthCare Provider Services at 844-289-2264.
Impacted Medication | Change | New Limit |
|---|---|---|
Wellfola | New Status | Non-preferred |
To our provider partners in healthcare,
This is an essential message from YouthCare HealthChoice Illinois (YouthCare).
Coverage of the medications listed below will change, effective August 1, 2024. For questions, please call YouthCare Provider Services at 844-289-2264.
Impacted Medication | Change | New Limit |
|---|---|---|
GENICIN VITA-Q
| New Status | Non-preferred |
FOLIKA-MG
| New Status | Non-preferred |
TM-DAILY | New Status | Non-preferred |
STROVITE ONE | New Status | Non-preferred |
MVW Complete | New Status | Non-preferred |
STROVITE FORTE | New Status | Non-preferred |
To our provider partners in healthcare,
This is an essential message from YouthCare HealthChoice Illinois (YouthCare).
Coverage of the medications listed below will change, effective August 1, 2024. For questions, please call YouthCare Provider Services at 844-289-2264.
Impacted Medication | Change | New Limit |
|---|---|---|
TWIST TOP LANCETS 30G | New Status | Non-Preferred |
NOVA SAFETY LANCETS 28G | New Status | Non-Preferred |
NOVA SAFETY LANCETS 23G | New Status | Non-Preferred |
LANCETS 30G TWIST TOP | New Status | Non-Preferred |
ULTILET SAFETY LANCETS 21G X 2.2MM | New Status | Non-Preferred |
ULTILET LANCETS 33G | New Status | Non-Preferred |
SMARTEST LANCETS 28G | New Status | Non-Preferred |
HAEMOLANCE | New Status | Non-Preferred |
HAEMOLANCE LOW FLOW LANCETS | New Status | Non-Preferred |
ASSURE HAEMOLANCE PLUS PEDIATRIC BLADE | New Status | Non-Preferred |
ASSURE HAEMOLANCE PLUS HIGH FLOW 18G | New Status | Non-Preferred |
ASSURE HAEMOLANCE PLUS NORMAL FLOW 21G | New Status | Non-Preferred |
ASSURE HAEMOLANCE PLUS LOW FLOW 25G | New Status | Non-Preferred |
ASSURE HAEMOLANCE PLUS MICRO FLOW 28G | New Status | Non-Preferred |
HAEMOLANCE PLUS | New Status | Non-Preferred |
HAEMOLANCE PLUS PEDIATRIC FLOW | New Status | Non-Preferred |
HAEMOLANCE PLUS MAX FLOW | New Status | Non-Preferred |
HAEMOLANCE PLUS | New Status | Non-Preferred |
HAEMOLANCE PLUS HIGH FLOW | New Status | Non-Preferred |
HAEMOLANCE PLUS LOW FLOW | New Status | Non-Preferred |
SAFE-T-LANCE PLUS SAFETYLANCET HIGH FLOW | New Status | Non-Preferred |
SAFE-T-LANCE PLUS SAFETYLANCET NORMAL FLOW | New Status | Non-Preferred |
SAFE-T-LANCE PLUS SAFETYLANCET LOW FLOW | New Status | Non-Preferred |
ULTILET SAFETY LANCETS 21G X 2.2MM | New Status | Non-Preferred |
SAFETY LANCETS 21G | New Status | Non-Preferred |
UNISTIK 3 GENTLE | New Status | Non-Preferred |
IN TOUCH STERILE LANCETS30G | New Status | Non-Preferred |
ACCU-CHEK SAFE-T-PRO LANCETS | New Status | Non-Preferred |
BD MICROTAINER LANCETS | New Status | Non-Preferred |
FREESTYLE UNISTICK II LANCETS | New Status | Non-Preferred |
HAEMOLANCE PLUS | New Status | Non-Preferred |
HAEMOLANCE PLUS | New Status | Non-Preferred |
HAEMOLANCE PLUS LOW FLOW | New Status | Non-Preferred |
UNISTIK 3 GENTLE | New Status | Non-Preferred |
TRAVEL LANCETS 30G | New Status | Non-Preferred |
SHOPKO ON-THE-GO COMFORTLANCETS 30G | New Status | Non-Preferred |
WALGREENS ADVANCED TRAVELLANCETS 28G | New Status | Non-Preferred |
COAGUCHEK LANCETS | New Status | Non-Preferred |
ACCU-CHEK SAFE-T-PRO PLUSLANCETS | New Status | Non-Preferred |
SOLUS V2 PRESSURE ACTIVATED SAFETY LANCETS 28G | New Status | Non-Preferred |
TRUEPLUS SAFETY LANCETS 28G | New Status | Non-Preferred |
TRUEPLUS SAFETY LANCETS 28G | New Status | Non-Preferred |
TRUEPLUS SAFETY LANCETS 28G | New Status | Non-Preferred |
TRUEPLUS SAFETY LANCETS 28G | New Status | Non-Preferred |
TRUEPLUS SAFETY LANCETS 28G | New Status | Non-Preferred |
DRUG MART ON-THE-GO LANCETS GENTLE 30G | New Status | Non-Preferred |
UNISTIK 3 GENTLE | New Status | Non-Preferred |
UNISTIK 3 GENTLE | New Status | Non-Preferred |
SAPS HEALTH PLUS TWIST TOP LANCETS 30G | New Status | Non-Preferred |
TRUE COMFORT TWIST TOP LANCETS 30G | New Status | Non-Preferred |
GLOBAL INJECT EASE LANCETS 28G | New Status | Non-Preferred |
GLOBAL INJECT EASE LANCETS 30G | New Status | Non-Preferred |
EMBRACE PRESSURE ACTIVATED SAFETY LANCET/21G | New Status | Non-Preferred |
EMBRACE PRESSURE ACTIVATED SAFETY LANCET/28G | New Status | Non-Preferred |
VERIFINE SAFETY LANCET MINI 28G X 1.8MM | New Status | Non-Preferred |
VERIFINE SAFETY LANCET MINI 30G X 1.8MM | New Status | Non-Preferred |
VERIFINE SAFETY LANCET MINI 21G X 2.4MM | New Status | Non-Preferred |
VERIFINE SAFETY LANCET MINI 23G X 1.8MM | New Status | Non-Preferred |
TRAVEL LANCETS ADVANCED 28G | New Status | Non-Preferred |
CLEVER CHOICE COMFORT EZLANCETS 28G | New Status | Non-Preferred |
CLEVER CHOICE COMFORT EZLANCETS 23G | New Status | Non-Preferred |
CLEVER CHOICE COMFORT EZLANCETS 21G | New Status | Non-Preferred |
CLEVER CHOICE COMFORT EZLANCETS 21G | New Status | Non-Preferred |
CLEVER CHOICE COMFORT EZLANCETS 28G | New Status | Non-Preferred |
CLEVER CHOICE COMFORT EZLANCETS 23G | New Status | Non-Preferred |
LANCETS 33G UNIVERSAL DESIGN | New Status | Non-Preferred |
ULTRA-THIN II AUTO LANCET | New Status | Non-Preferred |
MONOLETTOR SAFETY LANCETS | New Status | Non-Preferred |
LANCETS | New Status | Non-Preferred |
BD MICROTAINER LANCETS | New Status | Non-Preferred |
BD MICROTAINER LANCETS | New Status | Non-Preferred |
SAFETY LANCETS | New Status | Non-Preferred |
PHARMACIST CHOICE ULTRA THIN LANCETS | New Status | Non-Preferred |
PHARMACIST CHOICE ULTRA THIN LANCETS | New Status | Non-Preferred |
PHARMACIST CHOICE ULTRA THIN LANCETS 33G | New Status | Non-Preferred |
PHARMACIST CHOICE ULTRA THIN LANCETS 33G | New Status | Non-Preferred |
COMFORT TOUCH LANCETS ULTRA THIN 31G | New Status | Non-Preferred |
EASY COMFORT LANCETS 30G/THIN TOP | New Status | Non-Preferred |
SAPSCARE TWIST TOP LANCETS 30G | New Status | Non-Preferred |
ADVOCATE SAFETY LANCETS | New Status | Non-Preferred |
SAPS HEALTH TWIST TOP LANCETS 30G | New Status | Non-Preferred |
SAPS HEALTH CARE TWIST TOP LANCETS | New Status | Non-Preferred |
AQUALANCE LANCETS ULTRA THIN 30G | New Status | Non-Preferred |
ASSURE COMFORT LANCETS ULTRA THIN 28G | New Status | Non-Preferred |
EASY COMFORT LANCETS | New Status | Non-Preferred |
PRO COMFORT LANCETS 30G | New Status | Non-Preferred |
PRO COMFORT LANCETS 31G | New Status | Non-Preferred |
VERIFINE UNIVERSAL LANCETS 33G | New Status | Non-Preferred |
VERIFINE UNIVERSAL LANCETS 30G | New Status | Non-Preferred |
VERIFINE UNIVERSAL LANCETS 28G | New Status | Non-Preferred |
EASY COMFORT LANCETS 30G/PULL TOP | New Status | Non-Preferred |
COMFORT TOUCH LANCETS ULTRA THIN 31G | New Status | Non-Preferred |
PHARMACIST CHOICE ULTRA THIN LANCETS 31G | New Status | Non-Preferred |
LANCETS 30G | New Status | Non-Preferred |
EASY COMFORT LANCETS TWIST TOP | New Status | Non-Preferred |
ADVOCATE LANCETS | New Status | Non-Preferred |
ADVOCATE LANCETS | New Status | Non-Preferred |
CARETOUCH SAFETY LANCETS/26G | New Status | Non-Preferred |
CARETOUCH SAFETY LANCETS/28G | New Status | Non-Preferred |
CARETOUCH SAFETY LANCETS/30G | New Status | Non-Preferred |
COMFORT TOUCH PLUS SAFETY LANCETS PRESSURE ACTIVATED 28G | New Status | Non-Preferred |
SAFETY LANCETS 21G | New Status | Non-Preferred |
SAFETY LANCETS 23G | New Status | Non-Preferred |
SAFETY LANCETS 28G | New Status | Non-Preferred |
SAFETY LANCETS/PRESSURE ACTIVATED/28G | New Status | Non-Preferred |
CLEVER CHOICE COMFORT EZLANCETS 28G | New Status | Non-Preferred |
TRUE COMFORT SAFETY LANCETS/30G | New Status | Non-Preferred |
SAFETY LANCET 30G/PRESSURE ACTIVATED | New Status | Non-Preferred |
TRUE COMFORT TWIST TOP LANCETS 30G | New Status | Non-Preferred |
PURE COMFORT LANCETS 30G | New Status | Non-Preferred |
PRO COMFORT SAFETY LANCETS 30G PRESSURE ACTIVATED | New Status | Non-Preferred |
ADVOCATE SAFETY LANCETS 26G | New Status | Non-Preferred |
COMFORT TOUCH PLUS SAFETY LANCETS PRESSURE ACTIVATED 30G | New Status | Non-Preferred |
SAFETY LANCETS 28G | New Status | Non-Preferred |
COMFORT TOUCH PLUS SAFETY LANCETS PRESSURE ACTIVATED 28G | New Status | Non-Preferred |
To our provider partners in healthcare,
This is an essential message from YouthCare HealthChoice Illinois (YouthCare).
Coverage of the medications listed below will change, effective August 1, 2024. For questions, please call YouthCare Provider Services at 844-289-2264.
Impacted Medication | Change | New Limit |
|---|---|---|
Alcohol Prep Pads | New Status | Non-Preferred |
ALCOHOL PREP PADS | New Status | Non-Preferred |
SAPS HEALTH ALCOHOL PREPPADS | New Status | Non-Preferred |
PURE COMFORT ALCOHOL PREPPADS | New Status | Non-Preferred |
TRUE COMFORT ALCOHOL PREP PADS | New Status | Non-Preferred |
EASY COMFORT ALCOHOL PADS | New Status | Non-Preferred |
ALCOHOL PREP PADS | New Status | Non-Preferred |
SAPS HEALTH ALCOHOL PREPPADS | New Status | Non-Preferred |
SAPS HEALTH CARE ALCOHOLPREP PADS | New Status | Non-Preferred |
SAPS CARE ALCOHOL PREP PADS | New Status | Non-Preferred |
PRO COMFORT ALCOHOL PADS | New Status | Non-Preferred |
PHARMACIST CHOICE ALCOHOL PRED PADS | New Status | Non-Preferred |
ALCOHOL PADS | New Status | Non-Preferred |
ALCOHOL PREP PAD | New Status | Non-Preferred |
ALCOH-GLOVE CONTOURED WIPE | New Status | Non-Preferred |
To our provider partners in healthcare,
This is an essential message from YouthCare HealthChoice Illinois (YouthCare).
YouthCare would like to inform you that the status of the medications listed below will be changing on June 1, 2024.
For questions, please call YouthCare Provider Services at 844-289-2264.
Impacted Medication | Change | New Limits |
|---|---|---|
Symbicort Inhaler | Monthly limit | Increase to 2 inhalers per month |
2023 Illinois YouthCare Preferred Drug List Updates
This is an important message from YouthCare HealthChoice Illinois (YouthCare).
YouthCare would like to inform you that the coverage of the medications listed below has changed, effective 10/01/2023, for all members. Please reference the table for information regarding medication changes.
Impacted Medication | Change | Preferred Agents |
|---|---|---|
AUVI-Q (Auto-Injector)
| PREFERRED
| NA |
ORSERDU (Tabs)
| PREFERRED
| NA |
ENDARI (Pack) | PREFERRED
| NA |
Please note: Active prior authorizations for this medication will not be affected.
If you have any questions, please call YouthCare Provider Services at 844-289-2264.
This is an essential message from YouthCare HealthChoice Illinois (YouthCare).
YouthCare would like to inform you that the status of the medications listed below will be changing on October 15th, 2023.
Impacted Medication | Change | Alternative |
|---|---|---|
Mirena, CPT code J7298 | Not covered under pharmacy benefit | Covered under medical benefit |
Liletta, CPT code J7297 | Not covered under pharmacy benefit | Covered under medical benefit |
Skyla, CPT code J7301 | Not covered under pharmacy benefit | Covered under medical benefit |
Kyleena, CPT code J7296 | Not covered under pharmacy benefit | Covered under medical benefit |
Paragard, Intrauterine copper CPT code J7300 | Not covered under pharmacy benefit | Covered under medical benefit |
If you have any questions, please call YouthCare Provider Services at 844-289-2264.
This is an essential message from YouthCare HealthChoice Illinois (YouthCare).
YouthCare would like to inform you that the status of the medications listed below will be changing on October 15th, 2023.
| Impacted Medication | Change |
|---|---|
| Albuterol Sulfate Syrup
| Non-Preferred |
If you have any questions, please call YouthCare Provider Services at 844-289-2264.
This is an important message from YouthCare HealthChoiceIllinois (YouthCare).
YouthCare would like to inform you that the coverage of the medications listed below has changed, effective 07/01/2023, for all members. Please reference the table for information regarding medication changes.
Impacted Medication | Change of as 7/1/2023 | Preferred Agents |
|---|---|---|
ALBUTEROL SULFATE | NON-PREFERRED | NA |
SUNLENCA (TBPK, SOLN) | PREFERRED WITH PA
| NA |
EMGALITY (SOAJ, SOSY) | PREFERRED WITH PA
| NA |
LURASIDONE HYDROCHLORIDE (TABS) | PREFERRED
| NA |
MAVYRET (PACK, TABS) | PREFERRED
| NA |
SOFOSBUVIR/VELPATASVIR | PREFERRED
| NA |
Please note: Active prior authorizations for this medication will not be affected.
If you have any questions, please call YouthCare Provider Services at 844-289-2264.
This is an important message from YouthCare HealthChoice Illinois (YouthCare).
YouthCare would like to inform you that the coverage of the medications listed below will change, effective July 1, 2023, for all members. Please reference the table for information about medication changes.
Impacted Medication | Change | Preferred Agents |
|---|---|---|
Invega Hafyera | New Age Limit: Minimum age of 18 years | NA |
Invega Trinza | New Age Limit: Minimum age of 18 years | NA |
Invega Sustenna | New Age Limit: Minimum age of 18 years | NA |
Vraylar | New Age Limit: Minimum age of 18 years | NA |
Please note: Active prior authorizations for this medication will not be affected.
If you have any questions, please call YouthCare Provider Services at 844-289-2264.
This is an important message from YouthCare HealthChoice Illinois (YouthCare).
YouthCare would like to inform you that the coverage of the medications listed below will change, effective May 15, 2023, for all members. Please reference the table for information about medication changes.
Impacted Medication | Change | Preferred Agents |
|---|---|---|
Aripiprazole IM For ER Susp Prefilled Syringe 300 MG | New Age Limit: Minimum age of 18 years | NA |
Aripiprazole IM For ER Susp Prefilled Syringe 400 MG | New Age Limit: Minimum age of 18 years | NA |
Aripiprazole IM For Extended Release Susp 300 MG | New Age Limit: Minimum age of 18 years | NA |
Aripiprazole IM For Extended Release Susp 400 MG | New Age Limit: Minimum age of 18 years | NA |
Please note: Active prior authorizations for this medication will not be affected.
If you have any questions, please call YouthCare Provider Services at 844-289-2264.
This is an essential from YouthCare HealthChoice Illinois (YouthCare).
YouthCare would like to inform you that initial prescription logic used for opioids and benzodiazepines will be changing on May 8, 2023.
Impacted Medication | Change |
|---|---|
Opioids | Initial fill limit will be a maximum of 5 days' supply |
Benzodiazepines | Initial fill limit will be a maximum of 14 days' supply |
After the initial fill, prescriptions for these medications may be filled for a 30 days' supply.
The initial fill limit applies to participants who have not had another opioid or benzodiazepine claim within the previous 60 days.
For patients who have been diagnosed with a chronic painful condition, such as cancer or sickle cell disease, providers can ask for prior authorization for starting chronic opioid therapy. Upon approval, the 5-day initial fill limit will be waived. Those who have a prescription will subsequently be eligible for ongoing 30-day refills without further prior authorization restrictions
If you have any questions, please call YouthCare Provider Services at 844-289-2264.
This is an important message from YouthCare HealthChoice Illinois (YouthCare).
YouthCare would like to inform you that the coverage of the medications listed below has changed, effective April 1, 2023, for all members. Please reference the table for information regarding medication changes.
| Impacted Medication | Change | Preferred Agents |
|---|---|---|
AUSTEDO PATIENT TITRATION KIT (TBPK) | Preferred with PA | NA |
AUSTEDO (TABS) | Preferred with PA | NA |
| INGREZZA (CAPS) | Preferred with PA | NA |
| INGREZZA (CPPK) | Preferred with PA | NA |
| BERINERT | Preferred with PA | NA |
Please note: Active prior authorizations for this medication will not be affected.
If you have any questions, please call YouthCare Provider Services at 844-289-2264.
This is an important message from YouthCare HealthChoice Illinois (YouthCare).
YouthCare would like to inform you that the status of the medications desmopressin acetate and oxybutynin chloride will change on May 1, 2023, for members under the care of the Department of Children and Family Services.
The medicines will require form CFS 431-A (also known as a consent form) to be submitted to DCFS when prescribed within 100 days of the below medication.
Aripiprazole |
Aripiprazole Lauroxil |
Asenapine Maleate |
Asenapine TD Patch |
Brexipiprazole |
Cariprazine HCL |
Clozapine |
Iloperidone |
Lithium |
Lumateperone Tosylate |
Lurasidone HCl |
Olanzapine |
Olanzapine Pamoate |
Olanzapine-Fluoxetine |
Olanzapine-Samidorphan L-Malate |
Paliperidone |
Paliperidone Palmitate |
Quetiapine Fumarate |
Risperidone |
Risperidone Microspheres |
Ziprasidone HCl |
Ziprasidone Mesylate |
Please fax form CFS 431-A to 312-814-7015.
Note: Active consent for these medications will not be affected.
If you have any questions, please call YouthCare Provider Services at 844-289-2264.
YouthCare would like to inform you that the status of the medications listed below will change.
| Impacted Medication | Change |
|---|---|
All Enbrel Products | Preferred with Prior Authorization after 02/01/2023 |
Tamiflu Brand | Non-preferred after 03/01/2023 |
If you have any questions, please call YouthCare Provider Services at 844-289-2264.
YouthCare would like to inform you that the status of the medications listed below will be changing on February 1, 2023.
Impacted Medication | Change |
|---|---|
All Enbrel Products | Preferred with PA |
If you have any questions, please call YouthCare Provider Services at 844-289-2264.
This is an essential message from YouthCare HealthChoice Illinois (YouthCare).
YouthCare would like to inform you that the status of the medications listed below will be changing on February 1, 2023.
| Impacted Medication | Change |
|---|---|
All Enbrel Products | Non-Preferred |
Brand Strattera Capsule | Preferred |
Cosentyx; Cosentyx Sensoready pen | Preferred with Prior Authorization |
If you have any questions, please call YouthCare Provider Services at 844-289-2264.
2022 Illinois YouthCare Preferred Drug List Updates
This is an important message from YouthCare HealthChoice Illinois (YouthCare).
YouthCare would like to inform you that the status of the metformin listed below will be changing on December 1, 2022, for members under the care of the Department of Children and Family Services. The medicine will require form CFS 431-A (also known as a consent form) to be submitted to DCFS when prescribed within 100 days of the below medications
The medicines will require form CFS 431-A (also known as a consent form) to be submitted to DCFS when prescribed within 100 days of the below medication.
Aripiprazole |
Aripiprazole Lauroxil |
Asenapine Maleate |
Asenapine TD Patch |
Brexipiprazole |
Cariprazine HCL |
Clozapine |
Iloperidone |
Lithium |
Lumateperone Tosylate |
Lurasidone HCl |
Olanzapine |
Olanzapine Pamoate |
Olanzapine-Fluoxetine |
Olanzapine-Samidorphan L-Malate |
Paliperidone |
Paliperidone Palmitate |
Quetiapine Fumarate |
Risperidone |
Risperidone Microspheres |
Ziprasidone HCl |
Ziprasidone Mesylate |
Please fax form CFS 431-A to 312-814-7015.
Note: Active consent for these medications will not be affected.
If you have any questions, please call YouthCare Provider Services at 844-289-2264.
This is an important message from YouthCare HealthChoice Illinois (YouthCare).
YouthCare would like to inform you that the status of the medications listed below will be changing on November 1, 2022, for members under the care of the Department of Children and Family Services. The medicines will require form CFS 431-A (also known as a consent form) to be submitted to DCFS.
Please fax form CFS 431-A to 312-814-7015.
Brexipiprazole |
Bupropion Hydrobromide |
Desvenlafaxine |
Doxepin HCl (Sleep) |
Haloperidol Lactate (oral solution) |
Imipramine Pamoate |
Loxapine (aerosol) |
Naltrexone (Contrave ®) |
Naltrexone HCl-Bupropion HCl |
Naltrexone-Triamcinolone (Naltrexone implant) |
Nicotine Polacrilex (gum/llozenge) |
Olanzapine Pamoate |
Olanzapine-Samidorphan L-Malate |
Selegiline |
Viloxazine HCl (ADHD) |
Ziprasidone Mesylate |
Note: Active consent for these medications will not be affected.
If you have any questions, please call YouthCare Provider Services at 844-289-2264.
YouthCare would like to inform you that the coverage of the medications listed below has changed, effective October 1, 2022, for all members. Please reference the table for information regarding medication changes.
| Impacted Medication | Change | Preferred Agents |
|---|---|---|
INVEGA HAFYERA | Preferred with prior authorization after 10/1/22 | NA |
DYANAVEL XR | Preferred with prior authorization after 10/1/22 | NA |
JORNAY PM
| Preferred with prior authorization after 10/1/22 | NA |
MODAFINIL
| Preferred after 10/1/22 | NA |
| DAYTRANA | Non Preferred after 10/1/22 | NA |
Please note: Active prior authorizations for this medication will not be affected.
If you have any questions, please call YouthCare Provider Services at 844-289-2264.
Please read this important message from YouthCare HealthChoice Illinois (YouthCare) to all prescribers and providers.
Please be advised that coverage of the medications listed below is changing on July 1, 2022, for all members. Reference the table below for medication change information.
| Impacted Medication | Change | Preferred Agents |
|---|---|---|
APRETUDE | Preferred after 7/1/22 | NA |
CARGLUMIC ACID | Preferred, with a prior authorization after 7/1/22 | NA |
KERENDIA (except NDC: 50419054170) | Preferred, with a prior authorization after 7/1/22 | NA |
LIVTENCITY | Preferred, with a prior authorization after 7/1/22 | NA |
Note: Active prior authorizations for these medications will not be affected.
If you have any questions, please call YouthCare Provider Services at 844-289-2264.
YouthCare would like to inform you that the coverage of the medications listed below is changing on April 15, 2022 for all members. Please reference the table below for information regarding medication changes and alternative preferred agents.
YouthCare would like to work with you to help transition the impacted members onto a preferred formulary alternative. If a member requires continued therapy for a medication that has been changed, please submit a prior authorization with appropriate clinical documentation.
| Impacted Medication | Change | Preferred Agents |
|---|---|---|
FLUTICASONE PROPIONATE/SALMETEROL | Non-preferred after 4/15/22 | ADVAIR DISKUS® ADVAIR HFA® AIRDUO DIGIHALER 55/14® AIRDUO DIGIHALER 113/14® AIRDUO DIGIHALER 232/14® AIRDUO RESPICLICK 55/14® AIRDUO RESPICLICK 113/14® AIRDUO RESPICLICK 232/14® |
ADVAIR DISKUS ADVAIR HFA | Preferred after 4/15/22 | NA |
WIXELA INHUB | Non-preferred after 4/15/22 | ADVAIR DISKUS® ADVAIR HFA® AIRDUO DIGIHALER 55/14® AIRDUO DIGIHALER 113/14® AIRDUO DIGIHALER 232/14® AIRDUO RESPICLICK 55/14® AIRDUO RESPICLICK 113/14® AIRDUO RESPICLICK 232/14® |
AIRDUO DIGIHALER 55/14 AIRDUO DIGIHALER 113/14 AIRDUO DIGIHALER 232/14 | Preferred after 4/15/22 | NA |
AIRDUO RESPICLICK 55/14 AIRDUO RESPICLICK 113/14 AIRDUO RESPICLICK 232/14 | Preferred after 4/15/22 | NA |
ANORO ELLIPTA | Preferred after 4/15/22 | NA |
BEVESPI AEROSPHERE | Non-preferred after 4/15/22 | Anoro Elipta ® |
INCRUSE ELLIPTA | Preferred after 4/15/22 | NA |
SPIRIVA RESPIMAT | Preferred after 4/15/22 | NA |
MYFEMBREE | Preferred after 4/15/22 | NA |
QULIPTA | Preferred after 4/15/22 | NA |
APO-VARENICLINE | Non-preferred after 4/15/22 | Varinecline |
Note: Active prior authorizations for this medication will not be affected.
If you have any questions, please call YouthCare Provider Services at 844-289-2264.
Note: This notice replaces the previous notice dated 2/15/21.
2021 Illinois YouthCare Preferred Drug List Updates
YouthCare would like to inform you after August 1, 2021 melatonin will not be covered. This includes instances in which DCFS consent has been received. The change is being enacted due to the Center for Medicare and Medicaid’s (CMS) classification of melatonin and state of Illinois Department of Health and Family Services’ (HFS) rules.
For questions or additional information about this change please contact YouthCare Provider Services at 844-289-2264.
YouthCare would like to inform you that the coverage of long acting antipsychotic injectables (Abilify Maintena ®, Aristada ®, Aristada Initio ®, Invega Sustenna ®, and Invega Trinza ®) is changing on June 15, 2021 for all members. Effective June 15, 2021, these medications will be preffered with a prior authorization. Please reference the table below for information regarding medication changes and alternative preferred agents.
YouthCare would like to work with you to help transition the impacted members onto a preferred formulary alternative. If a member requires continued therapy for a medication that has been changed, please submit a prior authorization with appropriate clinical documentation. Prior authorizations can be submitted by faxing 844-989-0154.
Impacted Medication | Medication Change |
|---|---|
Abilify Maintena ® | Preferred with prior authorization after 6/15/2021 |
Aristada ® | Preferred with prior authorization after 6/15/2021 |
Aristada Initio ® | Preferred with prior authorization after 6/15/2021 |
Invega Sustenna ® | Preferred with prior authorization after 6/15/2021 |
Invega Trinza ® | Preferred with prior authorization after 6/15/2021 |
Note: Active prior authorizations for this medication will not be affected.
If you have any questions, please call YouthCare Provider Services at 844-289-2264.
YouthCare would like to inform you that the coverage of Metformin Hydrochloride ER Modified Release (GLUMETZA) and Metformin Hydrochloride ER Osmotic (FORTAMET) is changing on May 15, 2021 for all members. Effective May 15, 2021, this medication will be removed from the formulary. Please reference the table below for information regarding medication changes and alternative preferred agents.
YouthCare would like to work with you to help transition the impacted members onto a preferred formulary alternative. If a member requires continued therapy for a medication that has been changed, please submit a prior authorization with appropriate clinical documentation. Prior authorizations can be submitted by faxing 844-989-0154.
Impacted Medication | Medication Change | Preferred agents |
|---|---|---|
Metformin Hydrochloride ER Modified Release (GLUMETZA ®) | Non-preferred after 5/15/21 |
|
Metformin Hydrochloride ER Osmotic (FORTAMET ®) | Non-preferred after 5/15/21 |
|
Note: Active prior authorizations for this medication will not be affected.
If you have any questions, please call YouthCare Provider Services at 844-289-2264.