Please see the Copay Cap section, above, for more information on how MassHealth calculates this copay cap. MassHealth will calculate a monthly copay cap for you based on the lowest income in your household and your household size, as applicable. You will be given a monthly copay cap by MassHealth and this copay cap will not be more than 2% of your monthly household income each month. A copay cap is the highest dollar amount that a person can be charged in copays in a month. You are in another exempt category (see regulations at 130 CMR 506.015 or 130 CMR 520.037).Ī copay is a small amount that a person pays when they get health services.You are American Indian or an Alaska Native and you are currently receiving or have ever received services at the Indian Health Service (IHS), an Indian tribe, a tribal organization, or an urban Indian organization, or.You were a foster care child and you are eligible for MassHealth Standard, until age 21 or 26 as described in regulations at 130 CMR 505.002(H),.You’ve been admitted to a hospital from such a facility or hospital.Intermediate-care facility for individuals with intellectual disabilities.Chronic-disease or rehabilitation hospital, or.You are in a long-term care facility such as:.You are a member who has MassHealth Senior Buy-In or MassHealth Standard, and you are receiving a drug that is covered under Medicare Parts A and B only, when provided by a Medicare-certified provider,.You are receiving benefits under MassHealth Limited (Emergency Medicaid).You are pregnant or you’ve recently given birth (you’re in the postpartum period).You are eligible for MassHealth because you are receiving certain public assistance benefits such as Supplemental Security Income (SSI), Transitional Aid to Families with Dependent Children (TAFDC), or services through the Emergency Aid to the Elderly, Disabled and Children (EAEDC) Program.Your income is at or below 50% of the federal poverty level (FPL).You do not have to pay a MassHealth copay for any service covered by MassHealth if: Some members don’t have to pay a copay at all.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |