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Copayments:

$0.50 for OTC Drugs $1 for Generic Drugs $3 for Brand Name Drugs

Copayments are limited to $12 per member, per provider, per month. OTCs are excluded from this $12 maximum. Durable Medical Equipment (DME) Full coverage.

C-payment $0.50 to $3 per item (varies by item provided).

Rental items are not subject to a co-payment. Health Screenings for Children Full coverage of Health Check screenings and other services for individuals under age 21 years.

Copayment $1 per screening for those 18, 19 and 20 years of age. Hearing Services Full coverage.

Copayment $.50 to $3 per procedure.

No copayments for hearing aid batteries. Home Care Services (home health, private duty nursing and personal care) Full coverage.

No copayment. Hospice Full coverage.