NC Medicaid Copays
NC Medicaid is low or no-cost to you. NC Medicaid pays the cost for most health care services. You do not have to pay any monthly premiums. The highest copay is $4 and that is only needed for some services.
Copays
A copay is a fee you pay when you get certain health care services or prescriptions.
| Service | Copay |
|---|---|
| $4 per visit |
| Generic and brand prescriptions | $4 per prescription |
There are no NC Medicaid copays for the following members or services:
- Members under age 21
- Services related to pregnancy, childbirth, and postpartum care- to include prenatal care
- Members receiving hospice care
- Federally recognized tribal members or members receiving services through Indian Health Services (IHS)
- Members enrolled in Breast and Cervical Cancer Medicaid through the North Carolina Breast and Cervical Cancer Control Program (NC BCCCP) program
- Members residing in an institution who receive coverage for cost of care
- Members in foster care
- Behavioral health, intellectual/developmental disability (I/DD) or traumatic brain injury (TBI) services
- Members enrolled in NC Innovations and NC TBI waiver programs
- Members enrolled in Community Alternatives Programs for Children (CAP/C) and Disabled Adults (CAP/DA)
- Members enrolled in Long-Term Support Services (LTSS)
- Family Planning Services
- Services covered by Medicare and Medicaid
- Adult vaccines and vaccine administration
- HIV antiretroviral (ARV) medications
- Drugs used to reverse opioid overdose, drugs used to treat opioid use disorder and nicotine replacement drugs per the State Protocol
How to apply
The best way to find out if you are eligible is to apply.