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.