NY Health Access About Us   |   Contact Us Empire Justice Center Legal Aid Society NYLAG WNYLC

Medicaid Copayments in New York State

print  Print
share  Share
Views: 18666
Posted: 29 Sep, 2009
by Valerie Bogart (New York Legal Assistance Group)
Updated: 10 May, 2011
by Joe Kelemen (New York Legal Assistance Group)

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.


Attached files
item Increase_in_Medicaid_copays_and_new_copays_and_cuts_for_Family_Health_Plus.pdf (15 kb) Download
item Copayments NYS.doc (78 kb) Download

Prev     Next
Asking Medicaid to Pay for an Air Conditioner       Medicaid Utilization Thresholds (MUTS or UT) in NYS - Limits on...

This site provides general information only. This is not legal advice. You can only obtain legal advice from a lawyer. In addition, your use of this site does not create an attorney-client relationship. To contact a lawyer, visit http://lawhelpny.org. We make every effort to keep these materials and links up-to-date and in accordance with New York City, New York state and federal law. However, we do not guarantee the accuracy of this information. To report a dead link or other website-related problem, please e-mail us.