To support Medicaid-eligible people in Illinois living with HIV make informed decisions about their health care, the AIDS Foundation of Chicago (AFC) has released an overview of HIV medication coverage in selected Medicaid Managed Care plans.
“Navigating the complex world of Medicaid Managed Care plans as a consumer can be confusing, frustrating, or just plain scary,” said Matthew Frahm, medical benefits manager at AFC. “This is especially true if the medication you need isn’t covered, requires prior authorization, or is subject to strict prescribing limits.”
This resource is a map of Medicaid Managed Care companies’ prescription drug coverage and will help people living with or at risk for HIV and other chronic health conditions to make informed decisions about their health insurance coverage. Individuals can use the formulary review to compare the availability of medications across the various managed care plan options and work with their providers to find the best coverage for their unique situation. Please note: These formularies apply only to Medicaid plans; they do not apply to Affordable Care Act-powered Illinois Marketplace health insurance plans.
Insurers can make changes to their drug lists at any point, so AFC encourages clients and advocates to check before choosing a Medicaid MCO plan. For health insurance enrollment assistance, contact AFC’s Medical Benefits Coordinators at 312-784-9060. For questions related to this document, contact AFC Medical Benefits Manager Matt Frahm at 312-784-9071 or MFrahm@aidschicago.org.