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For most families, CHIP is free, with no copays or monthly premiums. For low-cost and full-cost members, some benefits require a copayment or “copay” that you pay directly to the provider each time your children get services. (If you are a low-cost or full-cost CHIP enrollee, we will notify you about your premium when we process your application.)
| Type of Service |
Free |
Low-Cost |
Full-Cost |
| PCP visits (sick care) |
$0 |
$5 |
$15 |
| Specialist visits |
$0 |
$10 |
$25 |
| Emergency Room (waived, if admitted) |
$0 |
$25 |
$50 |
| Prescriptions (Generic/Brand) |
$0 |
$6/$9 |
$10/$18 |
| Mental Health/Substance Abuse Outpatient Visits |
$0 |
$0 |
$25 |
There are no PCP copays for preventive care services, including well-child visits and visits for immunizations, for members in any premium category.
If your child is in the low-cost premium category, the maximum you will pay for copays annually is five percent of your family income.
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