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Elizabeth M. Whitehorn, Director

Out-of-Pocket Costs

 All Kids Out-of-Pocket Costs vary by Monthly Income and Family Size

Type of Service

All Kids Assist

All Kids Share

All Kids Premium Levels 1

All Kids Premium L

evel 2

Doctor Visits

 

$0.00

 

$3.90

 

$5.00

 

$10.00

Rx Brand/ Generic Meds

 

$0.00

$3.90 – Brand

$2.00 – Generic

$5.00 – Brand

$3.00 – Generic

$7.00 – Brand

$3.00 – Generic

 

ER Visits

 

$0.00

$0 – ER Visit

$0 - Non-

Emergency

$5.00 – ER Visit

$25.00 – Non-

Emergency

$30.00 – ER Visit

$30.00 – Non-Emergency

Hospital Admission

 

$0.00

 

$3.90/Admission

 

$5.00/Admission

 

$100/Admission

Hospital Outpatient Services

 

$0

 

$3.90 Visit

 

$5.00 Visit

 

5% of HFS Rate

Max Co- Pays/Yr

No Max

 

$100 per family (all services)

$100 per family (all services)

 

$500 per child

 

No Co-pay for American Indians and Alaska Natives

 

Co-pays apply for American Indians and Alaska Natives

***NO CO-PAYS FOR WELL BABY CARE, WELL CHILD CARE, PREVENTATIVE DENTAL, IMMUNIZATIONS, OR FLU SHOT*** CO-PAYS MAY APPLY IF CLIENT IS SEEN FOR AN UNRELATED REASON.

All Kids Hotline 1-866-ALL-KIDS (1-866-255-5437)

TTY: 1-877-204-1012