Section 128.320  Co-payments and Cost Sharing

a)         Co-payments or cost sharing may be charged for services provided to a veteran and spouse by a health care provider as described in subsection (b), except for practitioner visits scheduled for family planning services.

b)         Co-payment and cost sharing requirements are as follows:

1)         Practitioner office visits, $15;

2)         Dental visits, $15;

3)         Inpatient hospitalizations, $150 per hospital stay;

4)         Hospital or Ambulatory Surgical Treatment Center outpatient services set forth at 89 Ill. Adm. Code 148.140(b), 10 percent of the Department rate as set forth in Section 128.350(c);

5)         Hospital Emergency Visits, $50;

6)         Prescription drugs, $6 for a 1- to 30-day supply of generic drugs or $14 for a 1- to 30-day supply of brand name drugs.

c)         Providers are responsible for collecting co-payments.

d)         Providers may elect not to charge co-payments.  If co-payments are charged, the co-payment may not exceed the amounts established in this Section.

(Source:  Amended at 44 Ill. Reg. 19709, effective December 11, 2020)