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70 Population 2 (Unborn) Not applicable Population 3 (MCAP): 1.5 percent of the enrollee’s annual Modified Adjusted Gross
Income (MAGI) Population 4 (MCAIP): $13 per child per month with a maximum of $36 per family per month
8.2.2.
Deductibles:
8.2.3.
Coinsurance or copayments:
CA RESPONSE:
POPULATION 1 (CCHIP) Depending on the family income, the copayment may be $5, $10, or$15 a visit. The maximum out-of-pocket amount for services in one benefit year is $250/household.
No Copay: Preventative Care Services
Maternity Care
Medical Transportation
X-Ray and Laboratory Services
Inpatient Hospital Services
Durable Medical Equipment
Family Planning Services
Inpatient Mental Health
Serious Emotional Disturbance (SED)
Inpatient Alcohol and Substance Abuse Treatment
Inpatient Physical, Occupational, and Speech Therapy
Skilled Nursing Care
Dental: Preventative
Dental: Fillings
Dental: Sealants
Dental: Diagnostic X-Rays
Dental: Orthodontia
$10 Copay: Physician Services
Generic Prescription Drugs
Emergency Care Services
Outpatient Mental Health
Outpatient Alcohol and Substance Abuse Treatment
Outpatient Physical, Occupational, and Speech Therapy
Acupuncture (optional)
Chiropractic (optional)
Biofeedback (optional)