Illinois Medicaid fee-for-service uses HFS 3082 to request prior approval of a drug or an override of a pharmacy limit. Prescribers meet it when a medication needs prior approval or a claim hits an age, sex, quantity, daily dose or brand limit. The form collects the drug, diagnosis, clinical justification and prior medication failures, and is faxed to the HFS pharmacy prior authorization unit for review.
The prescriber or their office completes the whole form; the patient, prescriber and contact-person sections are marked required, and pharmacy details are added when known. The provider signs and dates it.
Download the current version from the source each time; forms change without notice.
Request for Drug Prior Approval
A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms and their requirements change without notice, so check the official page for the current version before you complete one.
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HFS 3082 is a dynamic XFA form built in Adobe LiveCycle. Browser PDF viewers and many preview apps cannot render it and display only a 'Please wait' message. Download the file and open it in Adobe Reader or Acrobat to see and fill in the fields.
The form has checkboxes for age, sex, brand name, the three-brand limit, maximum or minimum quantity, daily dose and an emergency 72-hour supply. Mark the limit involved and give the clinical justification and prior medication history so the HFS reviewer can decide the request.