If a member is enrolled in a health plan through MassHealth, what copayment should I charge?
You should follow the copayment rules of the MassHealth health plan. If the member is enrolled in Boston Medical Center HealthNet Plan, Neighborhood Health Plan, Network Health, or Fallon, there is no copayment for nonpharmacy (hospital) services. The only copayment that applies to MassHealth members enrolled in one of the above MassHealth health plans is for pharmacy services: • $1 for each prescription and refill of generic and over-the-counter drugs; and • $3 for brand-name drugs.
