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Drug Co-Payments

Traditional Medicaid and Hoosier Healthwise members who do not pay a monthly premium (Package A):

You may have to pay $3 for each of your drugs.  This amount is called a co-pay.  There are times in which you do not have a co-pay such as:

  • Services for members under the age of 18
  • Services related to a pregnancy
  • Services related to family planning (birth control and preventive supplies)
  • Services while in an emergency room or nursing home
  • Services while in a hospital

Hoosier Healthwise members who do pay a monthly premium (Package C):

Your co-pays will be $3 for each generic drug and $10 for each brand name drug.

HIP (Healthy Indiana Plan) and Presumptive Eligibility (PE) members:

If you are enrolled with HIP Basic, your co-pays will be $4 for each generic drug and $8 for each brand name drug.  If you'd like to learn more about the Healthy Indiana Plan, you should go to the Healthy Indiana Plan website.

If you are enrolled in the Adult category for Presumptive Eligibility (PE), your co-pays will be $4 for each generic drug and $8 for each brand name drug.

Emergency Supply:

Any medication dispensed as an Emergency Supply will not have a co-pay regardless of which Medicaid package you are enrolled in.

Days Supply on Prescriptions

Drugs you take for a long time (often called maintenance drugs) have a 100 days supply limit, while drugs you take for a shorter time (non-maintenance drugs) have a 34 days supply limit.  Maintenance drugs are taken for illnesses such as asthma, diabetes, and high blood pressure.  Non-maintenance drugs are generally taken for short term illness such as a cold, influenza or an infection.