Illinois § 30

§ 30.

Cost sharing. (a) Children enrolled in a health benefits program pursuant to subdivision (a)(2) of Section 25 and persons enrolled in a health benefits waiver program pursuant to Section 40 shall be subject to the following cost sharing requirements: (1) There shall be no co-payment required for well-baby or well-child care, including age-appropriate immunizations as required under federal law. (2) Health insurance premiums for family members, either children or adults, in families whose household income is above 150% of the federal poverty level shall be payable monthly, subject to rules promulgated by the Department for grace periods and advance payments, and shall be as follows: (A) $15 per month for one family member. (B) $25 per month for 2 family members. (C) $30 per month for 3 family members. (D) $35 per month for 4 family members. (E) $40 per month for 5 or more family members. (3) Co-payments for children or adults in families whose income is at or below 150% of the federal poverty level, at a minimum and to the extent permitted under federal law, shall be $2 for all medical visits and prescriptions provided under this Act and up to $10 for emergency room use for a non-emergency situation as defined by the Department by rule and subject to federal approval. (4) Co-payments for children or adults in families whose income is above 150% of the federal poverty level, at a minimum and to the extent permitted under federal law shall be as follows: (A) $5 for medical visits. (B) $3 for generic prescriptions and $5 for brand name prescriptions. (C) $25 for emergency room use for a non-emergency situation as defined by the Department by rule. (5) (Blank). (6) Co-payments shall be maximized to the extent permitted by federal law and are subject to federal approval. (b) (Blank). (Source: P.A. 97-74, eff. 6-30-11; 98-104, eff. 7-22-13.)