Co-payments and Cost Sharing

Section 128.320  Co-payments and Cost Sharing a)         Co-payments or cost sharing may be charged for services provided to a veteran and spouse by a health care provider as described in subsection (b), except for practitioner visits scheduled for family planning services. b)         Co-payment and cost sharing requirements are as follows: 1)         Practitioner office visits, $15; 2)         Dental visits, $15; 3)         Inpatient hospitalizations, $150 per hospital stay; 4)         Hospital or Ambulatory Surgical Treatment Center outpatient services set forth at 89 Ill. Adm. Code 148.140(b), 10 percent of the Department rate as set forth in Section 128.350(c); 5)         Hospital Emergency Visits, $50; 6)         Prescription drugs, $6 for a 1- to 30-day supply of generic drugs or $14 for a 1- to 30-day supply of brand name drugs. c)         Providers are responsible for collecting co-payments. d)         Providers may elect not to charge co-payments.  If co-payments are charged, the co-payment may not exceed the amounts established in this Section.