HHS Approves Illinois Plan To Cover Low-Income Seniors’ Drug Costs Under Medicaid
HHS on Jan. 28 approved Illinois' waiver proposal to cover drug costs for 368,000 low-income seniors under Medicaid. Under Illinois' current program, low-income seniors receive drug coverage only for "specific chronic and catastrophic medications." The waiver approval allows the state to expand the number of medications covered to all drugs covered by Medicaid. Through the approved plan, seniors with annual incomes of 200% of the federal poverty level, or $23,220 for a family of two, will pay an enrollment fee of $5 or $25, depending on income level, and a "nominal" copayment of $3 or less per drug. Medicaid then will pay the remainder of seniors' drug costs up to $1,750 per year. Beyond that limit, Medicaid will cover 80% of the cost for additional prescriptions, and seniors will be responsible for the remaining 20% of the cost, as well as the copayment. HHS Secretary Tommy Thompson said that the department will "make it easier financially and administratively for other states to quickly follow Illinois' lead," by allowing states to apply for the same waiver through Pharmacy Plus, a model demonstration application form. Pharmacy Plus features a streamlined waiver application that will be available electronically. The demonstration project is part of President Bush's effort to extend drug coverage to seniors (see story 1) (
HHS release, 1/28).
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