Page 267

Copayment $.50 to $3 per service (varies by service provided). Smoking Cessation Services Coverage includes prescription and over-the-counter tobacco cessation products.

Copayment (see drugs) Transportation Full coverage of emergency and non-emergency transportation to and from a certified provider for a BadgerCare Plus covered service. Copayments are:

$2 for non-emergency ambulance trips.

$1 per trip for transportation by an SMV. No copayment for transportation by common carrier or emergency ambulance.

If you or the member has additional questions, contact Member Services at 1-800-362-3002. 38.2.2 Copay Exempt Populations Providers are prohibited from collecting copayment from the following members: • Children under age 19, regardless of income or benefit program. ◦ Children in foster care, regardless of age. ◦ Children in adoption assistance, regardless of age. • American Indians or Alaskan Native Tribal members, the son or daughter of a tribal member, the grandson or granddaughter of a tribal member, or anyone otherwise eligible to receive Indian Health Services, regardless of age or income level, when they receive items and services either directly from an Indian health care provider or through referral under contract health services. • Former Foster Care Youth • Anyone receiving services through Express Enrollment • Pregnant Women 38.2.3 Copay Exempt Programs Copays will not be charged for members enrolled in the following subprograms: • Family Planning Only Services • Institutional Medicaid (not including childless adults (CLAs) enrolled in BadgerCare Plus and residing in an institution) • Katie Beckett • Wisconsin Well Woman Medicaid 38.2.4 Copay Exempt Services The following services do not require copayment: