Pharmacy Update: Initial Prescription Limit – Changes to Maximum Days’ Supply in Blue Cross Community Health PlansSM (BCCHPSM) 

January 23, 2023

Starting Feb. 1, 2023, Blue Cross and Blue Shield of Illinois (BCBSIL) updated prescription drug coverage for BCCHP members. BCBSIL will update the initial prescription logic used for opioids and benzodiazepines. This change was at the direction of the Department of Healthcare and Family Services (HFS) and will impact fee-for-service (FFS) as well as Managed Medicaid Health Plans.

  • For opioids, the initial fill limit will be a maximum of five days’ supply.
  • For benzodiazepines, the initial fill limit will be a maximum of 14 days’ supply.

After the initial fill, prescriptions for these drugs may be filled for a 30-day supply. The initial fill limit applies to members who have not had another opioid or benzodiazepine claim within the past 60 days. 

Please note: Benzodiazepines have no recognized role in pain control and could be hazardous (due to risk of respiratory depression and death) if prescribed for concurrent use with opioids.

Providers can request prior authorization for chronic opioid therapy for members with a diagnosis of chronic painful conditions, such as cancer or sickle cell disease. Upon approval, the five-day initial fill limit will be bypassed. Continuing 30-day refills will then be available to those members with a prescription without additional prior authorization requirements. 

Members can call the Member Services phone number on their BCBSIL ID card if they have any questions. Providers may also contact our Provider Customer Service line at 800-972-8088. Pharmacies may contact our Pharmacy Help Desk at 855-457-0173. 


1CDC Guideline for Prescribing Opioids for Chronic Pain, Nov. 03, 2022,

The above material is for informational purposes only and is not intended to be a substitute for the independent medical judgment of a physician. Physicians and other health care providers are encouraged to use their own best medical judgment based upon all available information and the condition of the patient in determining the best course of treatment. 

Prime Therapeutics LLC (Prime) is a separate pharmacy benefit management company contracted by BCBSIL to provide pharmacy benefit management and other related services. BCBSIL, as well as several Blue Cross and Blue Shield Plans, has an ownership interest in Prime Therapeutics.