Does ADHS/DBHS require co-payments for medications?
Provider Manual Section 3.4, Co-payments, states that co-payments are assessed for non-Title XIX/XXI persons determined to have a Serious Mental Illness (SMI) and are intended to be payments by the member for the entire service package (e.g., psychiatric assessments, medication management, medications). However, co-payments are only collected at the time of the psychiatric assessment and psychiatric follow up appointments. ADHS/DBHS co-payments are NOT collected for medications at the pharmacy. Co-payments do not apply to crisis services at this time.
Related Questions
- Are persons subject to an MOT order and who require psychotropic medications eligible to receive prescriptions from the Community Resource Pharmacy (CRP)?
- How will members know if their medications require prior authorization or have limitations?
- Does ADHS/DBHS fund room and board costs for Level II, III and HCTC for adults?
