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(215 ILCS 106/30)
(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
(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
(C) $25 for emergency room use for a
non-emergency situation as defined by the Department by rule.
(6) Co-payments shall be maximized to the extent
permitted by federal law and are subject to federal approval.
(Source: P.A. 97-74, eff. 6-30-11; 98-104, eff. 7-22-13.)