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UPDATED: JANUARY 2012

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OTHER ELIGIBILITY REQUIREMENTS

CO-PAY

Residents of Adult Care Facilities licensed by DOH or OMH and OPWDD certified community residences and recipients enrolled in a Comprehensive Medicaid Care Managed Program (CMCM), in an OPWDD Home and Community Based Services (HCBS) waiver program, or in a DOH HCBS waiver program for Persons with Traumatic Brain Injury (TBI).

Services Exempt from Co-Payment include the following:

Emergency Services

Family planning services, supplies, and treatment

Tuberculosis Directly Observed Therapy

Methadone Maintenance Treatment Programs, mental health clinic services, mental retardation clinic services, and alcohol and substance abuse clinic services

Drugs to treat tuberculosis, and birth control.

Psychotropic drugs

Prescription drugs for a resident of an Adult Care Facility licensed by the DOH.

NOTE: Co-payments are not charged by private physicians and dentists enrolled in Medicaid or, for home health and personal care services. Private physicians and dentists in Family Health Plus may charge a co-payment. (MRG)