New Jersey Administrative Code
Title 10 - HUMAN SERVICES
Chapter 167C - PROVISION OF PHARMACEUTICAL SERVICES UNDER THE SENIOR GOLD PROGRAM
Subchapter 1 - REQUIREMENTS FOR PROVISION OF PHARMACEUTICAL SERVICES
Section 10:167C-1.8 - Senior Gold Program co-payment
Universal Citation: NJ Admin Code 10:167C-1.8
Current through Register Vol. 56, No. 18, September 16, 2024
(a) Beneficiaries in the Program are responsible for a part of the cost of drugs and devices covered by the Program. At the point of sale, a Senior Gold beneficiary shall render to a pharmacy provider a fixed co-payment of $ 15.00 plus 50 percent of the remaining cost of the drug.
(b) A co-payment shall be rendered to a pharmacy provider for each original or refill prescription dispensed. The provider's usual and customary charge billed to the Program shall be inclusive of the co-payment amount which will be deducted by the New Jersey Medicaid Management Information System (NJMMIS).
1. Under no
circumstances is the required rendered co-payment amount to be waived for reasons of promotion, advertisement
and/or competitive considerations. Failure to comply with Program co-payment requirements may result in a
suspension of a provider's approval to participate in the Program.
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