CO-PAYMENT CHANGES TO MEDICAL ASSISTANCE BENEFITS

          HARRISBURG, January 4 - State Senator LeAnna M. Washington is alerting Medicaid recipients to be aware of changes to their co-payments for medical services or prescription drugs beginning January 13, 2006.

          Washington said that effective January 13, 2006, AmeriHealth Mercy Health Plan is changing the co-payments for medical assistance benefits. 

          The new co-payments are as follows: 

• Inpatient Medical Hospital (acute or rehab) admissions, you will pay $3 for each day, up to the maximum of $21 for each admission;

• Outpatient Hospital clinic visits, you will pay $1 for each visit; for Brand Name Prescription Drugs, and you will pay $3 for each new prescription or refill, if you have this benefit now;

• Medical supplies, you will pay up to $1 for each item;

• For ambulatory Surgical Center visits, you will pay $3 for each visit;

• Portable X-Ray services, you will pay $1 for each visit;

• Non-Emergency Ambulance services, you will pay $2 for each ambulance trip;

• Chiropractor services, you will pay $1 for each visit
   

          Co-payments do not apply if you are under age 18, pregnant, or live in a nursing home; to any services provided in an emergency situation; to services/items costing less than $2; to rental of Durable Medical Equipment; or to generic prescription drugs.

          Certain drugs do not have a co-payment such as: high blood pressure, cancer, diabetes, epilepsy, heart, psychosis, anti-Parkinson, anti Glaucoma, drugs used only to treat HIV/AIDS, or drugs, including immunizations, that you get in a health care provider’s office.

        You cannot be denied medical services or prescriptions if you cannot pay the co-payment.  Washington noted that these co-payment changes were the result of changes in state law, and as such, cannot be appealed, but complaints can be filed with AmeriHealth Mercy.