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Copays for Care

CHIP is free for most families with no copays or monthly premiums.

For low-cost and full-cost members, some benefits require a copayment or “copay” that you pay directly to the provider each time your children get services. If you are a low-cost or full-cost CHIP enrollee, we will notify you about your premium when we process your application.

Type of Service

Free

Low-Cost

Full-Cost

 

PCP visits
(sick care) 

$0 

$5 

$15

 

Specialist visits 

$0 

$5

$15

 

Emergency Room (waived, if admitted)

$0 

$25 

$50

 

Prescriptions (Generic/Brand) 

$0 

$6/$9 

$10/$18

 

Mental Health/
Substance Abuse outpatient visits 

$0 

$0 

$0

 

If your child is in the low-cost premium category, the maximum you will pay for copays annually is five percent of your family income. 

There are no PCP copays for preventive care services, including well-child visits and visits for immunizations, for members in any premium category.