Preferred Drug List (PDL) Updates
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 |
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 HealthChoice Illinois (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 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.
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.
YouthCare would like to inform you that the status of the medications listed below will be changing on February 1st, 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.
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
- Aripiprazole
- Olanzapine Pamoate
- Aripiprazole Lauroxil
- Olanzapine-Fluoxetine
- Asenapine Maleate
- Olanzapine-Samidorphan L-Malate
- Asenapine TD Patch
- Paliperidone
- Brexipiprazole
- Paliperidone Palmitate
- Cariprazine HCL
- Quetiapine Fumarate
- Clozapine
- Risperidone
- Iloperidone
- Risperidone Microspheres
- Lumateperone Tosylate
- Ziprasidone HCl
- Lurasidone HCl
- Ziprasidone Mesylate
- Olanzapine
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 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.
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.