NC Medicaid Copays

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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.


A copay is a fee you pay when you get certain health care services or prescriptions.

Service Copay
  • Doctor visits
  • Non-emergency and emergency department visits
  • Optometrist and optical visits
  • Outpatient visits
  • Podiatrist visits
  • Chiropractic visits
$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

How to apply

The best way to find out if you are eligible is to apply.

Learn How To Apply