NC Medicaid Copays
NC Medicaid is low or no-cost to you. NC Medicaid pays the cost for most health care services. You do not have to pay any monthly premiums. The highest copay is $4 and that is only needed for some services.
Copays
A copay is a fee you pay when you get certain health care services or prescriptions.
| Service | Copay |
|---|---|
|
$4 per visit |
| Generic and brand prescriptions | $4 per prescription |
There are no NC Medicaid copays for the following members or services:
- Members under age 21
- Services related to pregnancy, childbirth, and postpartum care- to include prenatal care
- Members receiving hospice care
- Federally recognized tribal members or members receiving services through Indian Health Services (IHS)
- Members enrolled in Breast and Cervical Cancer Medicaid through the North Carolina Breast and Cervical Cancer Control Program (NC BCCCP) program
- Members residing in an institution who receive coverage for cost of care
- Members in foster care
- Behavioral health, intellectual/developmental disability (I/DD) or traumatic brain injury (TBI) services
- Members enrolled in NC Innovations and NC TBI waiver programs
- Members enrolled in Community Alternatives Programs for Children (CAP/C) and Disabled Adults (CAP/DA)
- Members enrolled in Long-Term Support Services (LTSS)
- Family Planning Services
- Services covered by Medicare and Medicaid
- Adult vaccines and vaccine administration
- HIV antiretroviral (ARV) medications
How to apply
The best way to find out if you are eligible is to apply.