ARM 37.79.501

ARM 37.79.501. COST SHARING PROVISIONS

SupersededLast amended: 2004Length: 200 wordsOfficial source

Cite as Mont. Admin. R. 37.79.501

(1) Except as provided in (2) and (3) , the parent or guardian of each CHIP enrollee whose family income is greater than 100% of the federal poverty level must pay to the provider of service the following copayments not to exceed the cost of service: (a) $25 per admission for inpatient hospital services including hospitalization for physical, mental and substance abuse reasons; (b) $5 per visit for emergency room services; (c) $5 per visit for outpatient hospital visits including outpatient treatment for physical, mental and substance abuse reasons; (d) $3 per visit for physician, APRN, PA, optometrist, audiologist, mental health professional, substance abuse counselor or other covered health care provider services; (e) $3 per prescription or refill of an outpatient generic drug; and (f) $5 per prescription or refill for an outpatient brand-name drug; (2) No copayment shall apply to: (a) well baby or well child care, including age-appropriate immunizations; (b) outpatient hospital visits for x-ray and laboratory services; (c) dental, pathology, radiology or anesthesiology services; or (d) families with at least one enrollee who is a Native American Indian or Native Alaskan. (3) The total copayment for each family shall not exceed $215 per family per benefit year.
ARM 37.79.501: ARM 37.79.501. COST SHARING PROVISIONS | Justis AI