Monday, January 21, 2013

Spotlight: Illinois Healthy Women

Illinois Healthy Women is a limited eligibility program for women in Illinois that provides Illinois Department of Healthcare and Family Services (HFS) coverage for family planning (birth control) and certain services at a family planning visit.

The IHW card looks like an HFS Medical Card, but is pink in color. Providers credentialed with HFS are able to bill for IHW patients without additional credentialing. The standard HFS fee schedule applies.

Illinois Healthy Women is an excluded population for Illinois Health Connect. Patients who have IHW card are not required to pick a PCP with Illinois Health Connect and can be seen by any HFS provider

Patients whose only coverage is the Illinois Healthy Women card do not have medical coverage for services unrelated to family planning or reproductive health. Services that are covered at an IHW family planning visit are:
  • Physical exam and health history
  • Patient education and counseling about women's health, family planning and how to plan for a healthy pregnancy
  • Birth control
  • Pap tests
  • Sterilization services (patient's written consent needed) such as getting tubes tied, for patients who are at least 21 years old
  • Mammograms, when ordered by the doctor at family planning visit
  • Lab tests necessary for family planning, birth control or related reproductive health
  • Testing and medicine for sexually transmitted infections found during the family planning exam, including HIV testing
  • Multivitamins and folic acid
All IHW services must be billed with a family planning V25 diagnosis code. A complete list of IHW service codes is located on IHW website.