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This fact sheet explains which New York Medicaid recipients must pay copayments, and for which services. It also explains the $200 CAP, which limits how much any Medicaid recipient must pay in copayments in a year to $200. Note that for those who have both Medicare and Medicaid, called "dual eligibles", the copayments they pay for their prescription durgs to their Part D plan do not count toward the $200 cap. A bill has been proposed in the NYS Senate that would count these Part D copayments toward the $200 cap, so that if a dual eligible has a lot of prescriptions, when the copayments add up to $200 they will no longer have to pay any copayments. Medicaid would make up the difference in payment to the pharmacist. The sheet also explains that providers may not deny Medicaid services to those who say they are unable to pay Medicaid copayments. This article was authored by the Evelyn Frank Legal Resources Program of New York Legal Assistance Group.
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