Sec. 30. Cost sharing.

305 words·~1 min read·/il/chapter-215/act-106/30

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(a)Children enrolled in a health benefits program pursuant to subdivision (a)(2) of Section 25 and persons enrolled in a health benefits waiver program pursuant to Section 40 shall be subject to the following cost sharing requirements:

(1)There shall be no co-payment required for well-baby or well-child care, including

age-appropriate immunizations as required under federal law.

(2)Health insurance premiums for family members, either children or adults, in families

whose household income is above 150% of the federal poverty level shall be payable monthly, subject to rules promulgated by the Department for grace periods and advance payments, and shall be as follows:

(A)$15 per month for one family member.

(B)$25 per month for 2 family members.

(C)$30 per month for 3 family members.

(D)$35 per month for 4 family members.

(E)$40 per month for 5 or more family members.

(3)Co-payments for children or adults in families whose income is at or below 150% of

the federal poverty level, at a minimum and to the extent permitted under federal law, shall be $2 for all medical visits and prescriptions provided under this Act and up to $10 for emergency room use for a non-emergency situation as defined by the Department by rule and subject to federal approval.

(4)Co-payments for children or adults in families whose income is above 150% of the

federal poverty level, at a minimum and to the extent permitted under federal law shall be as follows:

(A)$5 for medical visits.

(B)$3 for generic prescriptions and $5 for brand name prescriptions.

(C)$25 for emergency room use for a non-emergency situation as defined by the

Department by rule.

(5)(Blank).

(6)Co-payments shall be maximized to the extent permitted by federal law and are

subject to federal approval.

(b)(Blank).