Skip to main content
  • Medicaid Provider Alert: Provider revalidation has begun and those not completing the process risk disenrollment.  Check your account now to learn when your revalidation is due. More information here.
Elizabeth M. Whitehorn, Director

Provider Notice issued 08/02/06

Illinois Medicaid Patients On Insulin

​To: ​Pharmacies
​Date: ​August 2, 2006
​Re: ​Illinois Medicaid Patients On Insulin

The Department has made a change to the PDL for insulin. Humalog and Humulin are now HFS's preferred insulin products.

In order to ease the transition to the preferred products, we will grandfather some of the patients on the non-preferred products. Those grandfathered prior approvals will have staggered end dates and will expire over the next few months.

When Medicaid patients present to fill their non-preferred insulin prescriptions over the next few months, please contact their doctor to request they be switched to a preferred product when clinically appropriate. If patients are switched now, this will prevent claims for these patients’ non-preferred insulin from requiring prior approval when the grandfathering period expires.

If the patient’s physician decides that there is a medical reason that a patient must continue to use an insulin product that is not preferred, a new prior approval must be requested.

Below is a list of insulin products available without prior approval. These products are listed as preferred on the Department’s PDL. If the physician determines that a patient must remain on non-preferred Novolin or Novolog insulin, a new prior approval must be requested. Prior approval may be requested by calling 1-800-252-8942, or by fax at 217-524-0404 or 217-524-7264.

Preferred Products

  • All Humulin Products

  • All Humalog Products

The Department appreciates the assistance of pharmacies in this effort. Your help in ensuring that, when possible, patients are proactively switched to preferred products before the grandfathering expires will make this transition easier for patients and their providers.

Please remember that in an emergency, pharmacies can dispense and be reimbursed for a 72-hour supply of medication. Because insulin cannot be dispensed as a 72-hour supply, this policy will allow pharmacies to dispense a full vial of insulin in an emergency and be reimbursed.