Copays

In some situations, former foster care individuals, who are adults (ages 21-25) and not receiving Title IV-E assistance, must share in the cost of the service provided.

This is a Copayment (or copay), or a set amount members pay when they receive a service.

• Member Copay Amounts include:
• Provider Visit: $4
• Preventative Visit: $0
• Prescriptions $4 or less
• Inpatient Hospital Stay: $10/day for the first seven (7) days. $5 on the eighth (8) day and beyond

Please refer to your Member Handbook (PDF) for complete information about copays and exemptions.

Paying Copays and other Payments

• You must make copays directly to providers at the time of service.
• You may be responsible for paying for non-covered services if you sign a release agreeing to pay before services are received. Note the cost of non-covered services is likely to be more than a copay for a covered service.

Exemptions

These types of members are always exempt from copays:

• AI/AN (American Indian/Alaskan Native)
• Pregnant Women for Pregnancy-Related Services
• Members receiving hospice care
• Children Under 21