Co-Pays
| Services | Standard & SSI Plan | Co-Pay |
|---|---|---|
| *Pharmacy | State drug list | $.50 - $3 * |
| Medication given during a healthcare provider visit | Full coverage | MHS covers |
| Physician visits | Full coverage | MHS covers |
| Inpatient hospital | Full coverage | MHS covers |
| Outpatient hospital | Full coverage | MHS covers |
| Emergency room | Full coverage | MHS covers |
| Nursing home | Full coverage | MHS covers |
| Physical therapy | Full coverage | MHS covers |
| Home health | Full coverage | MHS covers |
| Medical equipment | Full coverage | MHS covers |
| Medical supplies | Full coverage | MHS covers |
| *Transportation | Routine to & from covered services | Full coverage |
| Ambulance | Full coverage | MHS covers |
| *Dental | Preventive, restorative, palliative | *$1 - $3 |
| Vision | One exam & glasses per year | MHS covers |
| Added vision | $100 allowance for better frames or $80 toward contact lenses | MHS covers |
| Hearing | Full coverage | MHS covers |
| Hospice | Full coverage | No co-pay |
| Family planning | Full coverage | No co-pay |
| *Chiropractor | Full coverage | *$3 |
| Podiatrist | Full coverage | MHS covers |
| Mental health outpatient | Full coverage | MHS covers |
| Mental health inpatient | Full coverage for age 0-21. (Stays for ages 22-64 in institutional settings are not covered). | MHS covers |
| Residential treatment | Short-term coverage for substance abuse | *No co-pay |
| Health education | MHS added benefit | Asthma, diabetes, hypertension |
*Depending on your county of residence the dental benefit may be provided by MHS or by the state. Pharmacy and chiropractic services are provided by the state in all areas. You may access this care from any provider that will accept your ForwardHealth card. Routine transport is provided by the state through a separate company.
Services Not Covered
- Medically unnecessary services
- Reversal of voluntary sterilization
- Infertility treatments
- Surrogate parenting and related services
- Artificial insemination
- Inpatient mental health stays in institutional settings for ages 22 – 64
- Experimental procedures and treatments