April 30, 2025
The state of Illinois has made some coverage changes to the drug list (formulary) used by our Medicaid members who have prescription drug benefits through Blue Cross Community Health PlansSM . These changes went into effect March 13, 2025. Members impacted by these changes will be allowed to stay on their drug therapy until June 30, 2025.
Letters have been sent to the impacted members informing them of the coverage change and next steps to keep coverage:
- Switch the prescription to a preferred drug product before June 30, or
- Submit a prior authorization request for coverage exception before June 30.
A summary of the changes is below. Be sure to check the Drug List for BCCHPSM for more updates. Your patients may reach out to you about their coverage options.
Impacted Drug(s) |
Preferred Alternatives |
Preferred Alternatives’ NDCs |
Humalog vials, Humalog Jr Pens, Humalog Kwik Pens 100/ml |
INSULIN ASPA INJ 100/ML |
73070010011 |
INSULIN ASPA INJ FLEXPEN |
73070010310 73070010315 |
|
INSULIN ASPA INJ PENFILL |
73070010210 73070010215 |
|
INSULIN LISP INJ 100/ML |
00002773701 00002822201 00002822259 |
|
INSULIN LISP INJ JUNIOR |
00002775201 00002775205 |
|
Humira Pen/Kit/Inj |
ADALIMUMAB-ADBM PREFILLED SYRINGE KIT 40 MG/0.4 ML |
00597056520 |
ADALIMUMAB-ADBM AUTO-INJECTOR KIT 40 MG/0.4 ML |
00597057540 00597057550 00597057560 |
|
SIMLANDI KIT 20/0.2 ML |
51759038622 |
|
SIMLANDI 2PN INJ 40/0.4 ML |
51759040202 |
|
SIMLANDI 1PN KIT 40/0.4 ML |
51759040217 |
|
SIMLANDI KIT 40/0.4 ML |
51759041222 |
|
SIMLANDI KIT 80/0.8 ML |
51759052321 |
|
OneTouch Testing Strips/Kits |
CONTOUR PLUS BLOOD GLUCOSE TEST STRIPS |
00193758450 |
CONTOUR PLUS BLUE BLOOD GLUCOSE MONITORING SYSTEM |
00193703601 |
|
MICROLET LANCETS |
00193658621 |
|
MICROLET LANCET DEVICE |
00193670201 |
|
Humalog Kwik Inj 200/ml |
No change, remains preferred |
00002771201 00002771227 |
Humalog Inj 100/ml |
No change, remains preferred |
00002751601 00002751659 |