Plan Member Copays

Some members may be required to pay a copay, or a fee you pay when you get certain health care services from a provider or pick up a prescription from a pharmacy.

Service Your copay
Outpatient services
$4 per visit
Generic and brand prescriptions $4 per prescription
Optical services/supplies
$4 per visit
Non-emergency emergency department visit
$4 per visit

*There are no copays for the following members or services:

  • Members under age 21
  • Members who are pregnant
  • Members receiving hospice care
  • Federally recognized tribal members
  • North Carolina Breast and Cervical Cancer Control Program (NC BCCCP) beneficiaries
  • Children in foster care
  • People living in an institution who are receiving coverage for cost of care
  • Behavioral health services

A provider cannot refuse to provide services if you cannot pay. If you have any questions about Medicaid copays, please call Member Services at 1-855-375-8811 (TTY 1-866-209-6421).