Medicaid Copay For Doctor Visits

Patient Advocate Foundation's Co-Pay Relief program exists to help reduce the financial distress patients, and their families face when paying for treatment. We believe that no patient should go without life changing medications because they cannot afford them. We are here to help. If your Medicaid is with your LDSS, to order a new Medicaid Benefit Identification Card, please call or visit your local department of social services. If your Medicaid is with the Marketplace (NY State of Health) and you need to order a new benefit card please call the call center at 1-855-355-5777. Members residing in the five boroughs of NYC can call the HRA Infoline at 1 (718) 557-1399.

Copays for Medical Assistance and General Assistance members

Medicaid members 18 years of age and older and in the Medical Assistance or General Assistance categories will have to pay a copay for prescriptions and various medical services.

Members who are under the age of 18, pregnant, or in a nursing home do not have to pay the copays.

Residents of a long-term care facility or other medical institution, including intermediate care facilities, do not pay copays. Papas cupcakeriaobey games.

MA recipients, regardless of age, who qualify for benefits under Title IV-B Foster Care and Title IV-E Foster Care and Adoption Assistance do not pay copays.

PCP visits never have a copay.

Medical and General Assistance recipients cannot be denied a prescription if they cannot afford a copayment. If you cannot afford your prescription copayment, please let your pharmacist know. If you have any problems getting your medication from the pharmacist, please contact Member Relations at 1-800-553-0784 or 215-849-9600 (TTY 1-877-454-8477).

Medical Assistance copays

Medicare Doctor Visit Requirements

For the following services you will pay $5.00:

For acupuncture, you will pay $5.00 for each visit (up to 20 visits). Members who are pregnant or under age 21 do not need to pay a copay.

For the following services you will pay $3.00:

For inpatient hospital care (which includes both general and medical rehabilitation hospitals), you will pay $3.00 for each day you are in the hospital up to $21.00 for the stay
For Short Procedure Unit (SPU)/Ambulatory Surgical Center (ASC) visits, you will pay $3.00 per admission or visit.
For brand name prescription drugs, you will pay $3.00 for each prescription or refill.

For the following services, you will pay $1.00:

For outpatient x-ray services, you will pay $1.00 for the service (not for each x-ray).
For generic prescription drugs, you will pay $1.00 for each prescription or refill.
For chiropractor visits, you will pay $1.00 for each visit.

You don’t have to pay a copayment for any of the following if they are part of your benefit package: Action gamesloads of cool games.

Medicare Doctor Visit Copay

Any services provided in an emergency
Birth centers
Blood and blood products
Certain drugs for high blood pressure, cancer, diabetes, asthma, epilepsy, heart disease, psychosis, HIV/AIDS, glaucoma, depression, and anxiety, as well as anti-Parkinson agents, anti-manic agents, anti-convulsants, anti-neoplastic agents, oral contraceptives, test strips, lancets, meters, and needles
CRNP (Certified Registered Nurse Practitioner) services
Dental visits
Disposable medical supplies
Doctor's fee for x-rays, diagnostic tests, nuclear medicine or radiation therapy
Drugs and vaccines that you get in your doctor’s office
Family planning services
Home health agency services
Hospice services
Laboratory tests
Medical examinations for members under age 21 provided through the EPSDT program More than one of a series of specific allergy tests provided in a 24-hour period Non-emergency ambulance services
Nurse midwife (maternity services)
Optometrist visits
Oxygen
Physician visits
Podiatrist visits
Portable x-ray services
Renal dialysis services
Rental of Durable Medical Equipment (DME)
Skilled Nursing Facility
Targeted case management services
Tobacco cessation counseling services
Waiver services