The Illinois Department of Healthcare and Family Services (HFS) must approve medications after you fill 4 prescriptions in 30 days. This limit applies to adults and children. The limit sometimes applies to Medicaid recipients. It applies to those who are not enrolled in a Medicaid managed care plan.

The following types of drugs do not require prior approval:

• Oncolytics
• Anti-Retroviral Agents
• Contraceptives
• Immunosuppressives
• Antibiotics
• Over-the-counter drugs
• Non-drug items such as blood glucose test strips and monitors

Approvals last one year. In certain circumstances, short-term approval will be granted. When HFS is not available to process requests, a pharmacy can give out a 72-hour emergency supply.

There are several ways to check the status of a request:

• If you are a patient, you may call the Health Benefits Hotline at 1-800-266-0768 or 1-877-204-1012 (TTY).
• If you used the Medical Electronic Data Interchange (MEDI) system to enter a prior approval request, you can check the status by using the prior approval request number.

For more information on the four prescription policy, visit the HFS website.