Cost Sharing (Copayment)

Does Medicaid has copay or cost sharing ? How much Medicaid copay?

Cost Sharing (Copayment)

The copayment amount for physician office visit (including crossovers, and optometric) is $1.00 per visit. Copayment does not apply to services provided for pregnant women, nursing facility residents, recipients less than 18 years of age, emergencies, and family planning.

The provider may not deny services to any eligible Medicaid recipient because of the recipient’s inability to pay the cost-sharing (copayment) amount imposed.

Medicaid copayment and coinsurance - List of service and its copays - 2014

For certain Medicaid services, the recipient is responsible for a set copayment or coinsurance that is to be paid directly to the provider

Copayment

A copayment is a predetermined amount of money, specified by Medicaid, that the recipient pays to a provider.

Coinsurance 

A coinsurance is a percent of the Medicaid payment that the recipient pays to provider.

Medicare Crossovers