Current through Public Act 103-1052
Section 215 ILCS 106/30 - Cost sharing(a) Children enrolled in a health benefits program pursuant to subdivision (a)(2) of Section 25 and persons enrolled in a health benefits waiver program pursuant to Section 40 shall be subject to the following cost sharing requirements: (1) There shall be no co-payment required for well-baby or well-child care, including age-appropriate immunizations as required under federal law.(2) Health insurance premiums for family members, either children or adults, in families whose household income is above 150% of the federal poverty level shall be payable monthly, subject to rules promulgated by the Department for grace periods and advance payments, and shall be as follows: (A) $15 per month for one family member.(B) $25 per month for 2 family members.(C) $30 per month for 3 family members.(D) $35 per month for 4 family members.(E) $40 per month for 5 or more family members.(3) Co-payments for children or adults in families whose income is at or below 150% of the federal poverty level, at a minimum and to the extent permitted under federal law, shall be $2 for all medical visits and prescriptions provided under this Act and up to $10 for emergency room use for a non-emergency situation as defined by the Department by rule and subject to federal approval.(4) Co-payments for children or adults in families whose income is above 150% of the federal poverty level, at a minimum and to the extent permitted under federal law shall be as follows: (A) $5 for medical visits.(B) $3 for generic prescriptions and $5 for brand name prescriptions.(C) $25 for emergency room use for a non-emergency situation as defined by the Department by rule.(6) Co-payments shall be maximized to the extent permitted by federal law and are subject to federal approval. Amended by P.A. 098-0104,§ 7-10, eff. 7/22/2013.Amended by P.A. 097-0074,§ 10, eff. 6/30/2011.Amended by P.A. 094-0048, § 15, eff. 7/1/2005. P.A. 90-736, eff. 8-12-98; 91-266, eff. 7-23-99.