New Jersey Administrative Code
Title 10 - HUMAN SERVICES
Chapter 51 - PHARMACEUTICAL SERVICES MANUAL
Subchapter 1 - PHARMACEUTICAL SERVICES
Section 10:51-1.12 - Personal contribution to care requirements for NJ FamilyCare-Plan C and copayments for NJ FamilyCare-Plan D

Universal Citation: NJ Admin Code 10:51-1.12

Current through Register Vol. 56, No. 18, September 16, 2024

(a) General policies regarding the collection of personal contribution to care for NJ FamilyCare-Plan C and copayments for NJ FamilyCare-Plan D are set forth at N.J.A.C. 10:49-9.

(b) Personal contribution to care for NJ FamilyCare-Plan C services are $ 1.00 per dispensing for generics and $ 5.00 per dispensing for brand name drugs. Included in drugs are insulin, needles and syringes.

(c) Pharmacies are required to collect the personal contribution to care for the above-mentioned NJ FamilyCare-Plan C services if the NJ FamilyCare Identification Card indicates that a personal contribution to care is required and the beneficiary does not have a NJ FamilyCare form which indicates that the beneficiary has reached their cost share limit and no further personal contributions to care are required, until further notice. Personal contribution to care charges cannot be waived.

(d) The copayment for prescription drugs under NJ FamilyCare-Plan D shall be $ 5.00 per prescription:

1. If greater than a 34-day supply of a prescription drug is dispensed, a $ 10.00 copayment shall apply.

(e) Pharmacies shall collect the copayment specified in (d) above. Copayments shall not be waived.

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