Ill. Admin. Code tit. 89 § 128.320

Current through Register Vol. 48, No. 52, December 27, 2024

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.

Ill. Admin. Code tit. 89, § 128.320

Amended at 36 Ill. Reg. 17062, effective November 26, 2012

Amended at 44 Ill. Reg. 19709, effective 12/11/2020