Some adults may have to pay a small co-payment for some services.
Call 1-888-549-0820 if you have questions about which services require a co-payment.
You can only be required to pay for:
- Allowed co-payments
- Services that are not covered
- Services for which you have already used the limit allowed
The following beneficiaries do not have co-payment requirements:
- Children under 19 years of age
- Pregnant women
- Institutionalized individuals (such as persons in a nursing facility or ICF-MR)
- Members of a Federally Recognized Indian Tribe (for services rendered by the Catawbas Service Unit in Rock Hill, SC and when referred to a specialist or other medical provider by the Catawba Service Unit)
- Members of the Health Opportunity Account (HOA) program
The following services are not subject to a co-payment:
- Medical equipment and supplies provided by DHEC
- Orthodontic services provided by DHEC
- Family planning services
- End Stage Renal Disease (ESRD) services
- Infusion Center services
- Emergency services in the hospital emergency room
- Hospice benefits
- Waiver services
| CURRENT COPAY AMOUNTS
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| $1.15 (per date of service)
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$3.30 (per date of service)
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$3.40 (per date of service)
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$3.40 (per claim)
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$25.00 (per admission)
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| Chiropractor Services
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Doctor's office visits (Physician/Nurse Practitioner)
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*Durable Medical Equipment and Supplies
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Outpatient Hospital services (non-emergency)
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Inpatient Hospital
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| Podiatrist services
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Clinic Visits (Federally Qualified Health Center(FQHC), Rural Health Clinic (RHC), Ambulatory Surgical Center)
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Dental Services
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Home Health visits
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Prescriptions {per prescription/per refill}
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Optometrist Services
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