Medicaid covers certain medically necessary services for adults, including the following:

• Physician services.
• Skilled nursing care.
• Inpatient and outpatient hospital care.
• Optical (eye) services and supplies. There is a limit of one pair of adult eyeglasses every 2 years. This limit does not apply to people who need new eyeglasses because they had some surgery.
• Emergency dental services.
• Podiatric care (foot care) for diabetics.
• Chiropractic care.
• Renal dialysis.
• Psychiatric care.
• Special appliances and devices.
• Physical therapy.
• Prescription drugs. Prior approval is required for many drugs. The prior approval hotline is 1-800-252-8942. Medicaid will cover up to 4 prescriptions a month. If you have more than 4 prescriptions, you will need prior approval. Prior approval might not be necessary if your managed care plan has more flexible rules. Starting in 2024, Medicaid will also cover prenatal vitamins prescribed by a doctor.
• Alcoholism and substance abuse services.
• Hospice care.
• Medical equipment, supplies, and devices.
• Prosthetic devices.
• Transportation for medical purposes.
• Medically necessary institutional group care.
• Short term, intermittent, home health services. Starting in 2024, home health services will be covered for medically necessary care.
• Different medical services, such as lab and x-ray services, and family planning services and supplies.
• Nursing home care. If the person does not have a spouse, all income except $30 per month must be paid toward the nursing home costs. The normal income exemptions do not apply.
• Acupuncture services performed by a licensed acupuncturist acting within the scope of their license.
• Early and periodic screening, diagnostic, and treatment services (EPSDT) for individuals under the age of 21. 
• Treatment for mental, emotional, nervous, or substance use disorders and conditions.
• Counseling to help pregnant women stop smoking. 
• Perinatal doula services and evidence-based home visiting services. This covers:
  • regular visits beginning in the prenatal period,
  • during the postnatal period including during labor and delivery, and
  • during the postpartum period for up to 12 months.

Restrictions on funding for abortion from Medicaid and the State Employees Group Insurance Plan were removed in January, 2018.

Starting on January 1, 2023, Medicaid will also cover licensed certified professional midwife services.  The Department of Healthcare and Family Services will need to consult with midwives on reimbursement rates for midwifery services.

In May 2023, the Department of Healthcare and Family Services announced that telehealth flexibilities would continue past the end of the Covid-19 public health emergency. On January 1, 2024, a new Illinois law will ensure that telehealth services for mental health and substance use disorder treatment continue to be covered under Medicaid. These telehealth rules apply to both Medicaid fee-for-service and managed care plans.

Health insurance plans issued or renewed on or after January 1, 2025, must cover medically necessary:

• reconstructive services meant to restore physical appearance,
• hearing aids and related services, and
• prosthetic or custom orthotic devices that are doctor-recommended as the most appropriate model for physical activities.