MedicaidCoverageMedium impact
Changes to the Illinois Cares Rx program
Illinois Medicaid - HFS·IL · Pharmacy·Provider Notice
Effective date
Sep 1, 2011
We identified it
Jun 21, 2026
Summary
The Illinois Cares Rx program is lowering income eligibility limits and increasing copayments effective September 1, 2011, resulting in some members losing coverage. New copayment structures are established for both Medicare and non-Medicare beneficiaries with different amounts for generic, preferred brand, non-preferred brand, and specialty drugs.
Action Required
By September 1, 2011: Billing team must update patient eligibility verification procedures for Illinois Cares Rx members and modify copayment collection processes. Update billing system with new copayment amounts: Medicare beneficiaries ($5 generic, $15 preferred brand, $20 non-preferred brand, $15 specialty); non-Medicare beneficiaries ($5 generic, $15 preferred brand). Train front desk staff on new eligibility requirements as some current members will lose coverage.