Alabama Administrative Code
Title 560 - ALABAMA MEDICAID AGENCY
Chapter 560-X-1 - GENERAL
Section 560-X-1-.25 - Copayment (Cost-Sharing)

Universal Citation: AL Admin Code R 560-X-1-.25

Current through Register Vol. 42, No. 11, August 30, 2024

(1) Medicaid recipients are required to pay the designated copayment amount for the following services (including Medicare crossovers):

(a) Physician office visits (including optometric)

(b) Inpatient hospital admissions

(c) Outpatient hospital visits

(d) Rural health clinic visits

(e) Durable medical equipment

(f) Medical supplies

(g) Pharmaceutical

(2) The copayment amount does not apply to services provided for the following:

(a) Pregnancy

(b) Recipients under 18 years of age

(c) Family planning

(d) Emergencies

(e) Nursing Home Residents

(f) Native Americans

(3) In addition to the exemptions in (2) above, each service has other specific exemptions. Please refer to the appropriate chapter for a complete list of the exemptions.

(4) A provider may not deny services to any eligible individual due to the individual's inability to pay the cost-sharing amount imposed.

Author: Kathy Hall, Deputy Commissioner, Program Administration

Statutory Authority: State Plan, Attachment 4.18-A; Title XIX,Social Security Act; 42 C.F.R. §§ 447.15, 447.50, 447.55.

Disclaimer: These regulations may not be the most recent version. Alabama may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.