Pharmacy Copays

Preferred or approved nonpreferred prescription drugs: $1.00

There will be no prescription copay for members who:

• Fall under the designated income threshold (100% or below the federal poverty level).
• Are under 18 years of age.
• Are in a nursing facility, or an intermediate care facility for members with intellectual disabilities.
• Participate in one of the home and community-based services waiver programs.
• Are pregnant and receiving services related to their pregnancy or any other medical condition that might complicate the pregnancy.
• Are receiving services for conditions related to their pregnancy and the prescription is filled or refilled within 60 calendar days after the month the pregnancy ended.
• Are receiving hospice care.
• Are American Indian/Alaska Native.