WCDJFS - OHIO MEDICAID

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Medicaid Co-Pays

You may be charged a co-payment for the medical services listed below. Co-payments should be paid to your health care provider when you receive medical services. You can request a state hearing if you think you have been wrongfully charged a co-payment.

Service	Co-pay Amount
Non-emergency services obtained in a hospital emergency room	$3 per visit
Dental services	$3 per visit
Routine eye examinations	$2 per examination
Eyeglasses	$1 per fitting
Most brand name (non-generic) medications	$2 per prescription or refill
Medications that require prior authorization	$3 per prescription or refill

You will not be charged a co-payment if you are:

Under age 21,
Pregnant or your pregnancy ended up to 90 days ago (there are co-payments for routine eye examinations & eyeglasses fittings),
Living in a nursing home or an intermediate care facility for the mentally retarded,
Getting emergency services in a hospital, clinic, office or other facility,
Getting services related to family planning,
Getting hospice care, or
Are in a managed care plan that does not charge co-payments.

Ability to Pay Co-Pays:
If you are unable to pay your co-payment, you cannot be refused medical services. However, you still owe the co-payment to your health care services provider. Your health care services provider may refuse medical services if you have past unpaid co-payments. Your health care services provider must tell you that this is their policy and that they must have the same policy for all of their patients.

Got Medicare and Medicaid?

If you have Medicare, there is a prescription drug benefit program known as Medicare Part D that helps you pay for your prescriptions. Medicaid will only pay for certain prescriptions that Medicare Part D does not cover. Be sure to give both your Medicare Part D and your Medicaid cards to your pharmacist.

Also, you will automatically qualify for "extra help" so you will not be charged a deductible or monthly premiums. However, you will have to pay co-payments between $1 and $5 per prescription.