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Medicaid Copays

You may be charged a co-payment for the medical services listed below. Co-payments should be paid to your health care provider when you receive medical services. You can request a state hearing if you think you have been wrongfully charged a co-payment.

Call the Ohio Medicaid Consumer Hotline at (800) 324-8680 if you have more questions.

Service Copay Amount
 Non-emergency services obtained in a hospital or emergency room
 $3 per visit
 Dental services
 $3 per visit
 Eye examinations
 $2 per examination
 Eyeglasses  $1 per fitting
 Most brand name (non-generic) medications
 $2 per prescription refill
 Medications that require prior authorization
 $3 per prescription or refill

You will not be charged a copayment if: 

  • Younger than age 21
  • Pregnant or your pregnancy ended up 90 days ago (there are copayments for routine eye examinations & eyeglasses fittings)
  • Living in a nursing home or an intermediate care facility for the mentally retarded
  • Receiving emergency services in a hospital, clinic, office, or other facility
  • Receiving family planning-related services
  • Receiving hospice care
  • In a managed care plan that does not charge copayments

Ability to pay copays:

If you are unable to pay your copayment, you cannot be refused medical services. However, you still owe the copayment to your health care services provider. Your health care services provider may refuse medical services if you have past unpaid copayments. Your health care services provider must tell you that this is their policy and they must have the same policy for all of their patients.

Have Medicare and Medicaid?

If you have Medicare, there is a prescription drug benefit program known as Medicare Part D that helps you pay for your prescriptions. Medicaid will only pay for certain prescriptions that Medicare Part D does not cover. Be sure to give both your Medicare Part D and your Medicaid cards to your pharmacist.

Also, you will automatically qualify for "extra help" so you will not be charged a deductible or monthly premiums. However, you will have to pay copayments between $1 and $5 per prescription.

Consumer Hotline

Questions? Call the Ohio Medicaid Consumer Hotline at 800-324-8680

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