Cost-Sharing Provisions by State and Program, 2003 (Part 1)

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Presentation transcript:

Cost-Sharing Provisions by State and Program, 2003 (Part 1) State (Program) Income Eligibility (% FPL) Annual Fee/ Premium Deductible Coinsurance/Copay Benefit Cap Out of Pocket Cap CT 226% $30 $16.25 DE 200% $5 or 25%, whichever is greater $2,500 FL 120% $2/$5/$15 tiered copay $160 a month IL (Circuit Breaker) 236% $5 or $25 by income $0 or $3 by income up to $2,000 in drug costs. 20% coinsurance above $1,750 IL (Senior Care) <100% FPL, no copay. Up to 200% FPL $1 Generica, $4 Brand, up to $1,750. 20% coinsurance above $1,750 IN 135% 50% $500, $750, or $1,000 by income KS 30% $1,200 MA 500% $0 to $99 by income $0 to $125 a quarter by income $6/$16/50% or $40 to $10/$28/50% or $40 by income $2,000 or 10% of income, whichever is lower MD 116% $5