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Wisconsin Department of Health and Family Services Obsolete Medicaid Eligibility Handbook For the current MEH, see http://www.emhandbooks.wi.gov/meh-ebd/ For the current BC Plus Handbook, see http://www.emhandbooks.wi.gov/bcplus/ |
Clients are responsible for making a co-payment for many medical services and procedures. Children less than 18 years of age, nursing home residents and people in state-contracted or other MA managed care programs receiving managed care covered services are exempt from co-payments.
Medical services exempt from co-payments are:
Emergency hospital and ambulance services and emergency services related to the relief of dental pain.
Services related to pregnancy.
Family planning services and supplies.
Common carrier transportation, if provided through or paid for by a county/tribal human or social services department.
Home health services.
Personal care services.
Case management services.
Outpatient psychotherapy services received that exceed 15 hours or $500, whichever occurs first, during one calendar year.
Occupational, physical, or speech therapy services received that exceed 30 hours or $1,500 for any one therapy, whichever occurs first, during one calendar year.
Hospice care services.
Substance abuse (alcohol and other drug abuse) day treatment services.
Respiratory care for ventilator-assisted clients.
Community Support Program ( CSP ) services.
Providers are required to make a reasonable effort to collect the co-payment. Co-payments range from $0.50 to $3.00 for each procedure or service. Providers may not refuse services to a client who fails to make a co-payment.
This page last updated in Release Number : 03-02
Release Date: 04/01/03
Effective Date: 04/01/03
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