Child Health Insurance Cost

Health Check (Medicaid)

For Health Check (Medicaid), there are no yearly enrollment fees or co-payments.

NC Health Choice

For NC Health Choice, how much you pay depends on your family's income.

Either

• You will have small co-payments for prescription drugs

or

• You will have a yearly enrollment fee and small co-payments for prescription drugs, some office visits and non-emergency visits to the Emergency Room

Pharmacy Co-payments

All children in the NC Health Choice program have small co-payments for prescription drugs.

• $2 for each generic drug
• $2 for each brand name drug which doesn't have a generic substitute
• Either $5 or $10 for each brand name drug which does have a generic substitute

Whether you have to pay $5 or $10 depends on your family's income when you applied for NC Health Choice. Your child's NC Health Choice insurance card will tell you what you can expect to pay.

To reduce co-payments, you may want to ask your doctor if a generic drug substitution would be a good choice.

Yearly Enrollment Fee

Depending on your family's income, you may have to pay a yearly enrollment fee. The fee is $50 for one child or $100 for two or more children.

Office Visits and ER Co-payments

If you pay a yearly enrollment fee, you will have small co-payments for some visits to healthcare providers.

You WON'T have co-payments for:

• Checkups (well-child care visits)
• Shots (immunizations)
• Regular teeth cleaning (routine dental visits)

Co-payments are $5 for an office visit and $10 or $25 for a non-emergency visit to the emergency room

Note: Members of federally-recognized Indian tribes are exempt from co-payments and yearly enrollment fees.

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Last updated: October 2011