Illinois Compiled Statutes 215 ILCS 106 Children’s Health Insurance Program Act. Section 30

    (215 ILCS 106/30)

    Sec. 30. Cost sharing.

    (a) Children enrolled in a health benefits program pursuant to subdivision (a)(2) of Section 25 and persons enrolled in a health benefits waiver program pursuant to Section 40 shall be subject to the following cost sharing requirements:

        (1) There shall be no co-payment required for

    well-baby or well-child care, including age-appropriate immunizations as required under federal law.

        (2) Health insurance premiums for family members,

    either children or adults, in families whose household income is above 150% of the federal poverty level shall be payable monthly, subject to rules promulgated by the Department for grace periods and advance payments, and shall be as follows:

            (A) $15 per month for one family member.

            (B) $25 per month for 2 family members.

            (C) $30 per month for 3 family members.

            (D) $35 per month for 4 family members.

            (E) $40 per month for 5 or more family members.

        (3) Co-payments for children or adults in families

    whose income is at or below 150% of the federal poverty level, at a minimum and to the extent permitted under federal law, shall be $2 for all medical visits and prescriptions provided under this Act and up to $10 for emergency room use for a non-emergency situation as defined by the Department by rule and subject to federal approval.

        (4) Co-payments for children or adults in families

    whose income is above 150% of the federal poverty level, at a minimum and to the extent permitted under federal law shall be as follows:

            (A) $5 for medical visits.

            (B) $3 for generic prescriptions and $5 for brand

        name prescriptions.

            (C) $25 for emergency room use for a

        non-emergency situation as defined by the Department by rule.

        (5) (Blank).

        (6) Co-payments shall be maximized to the extent

    permitted by federal law and are subject to federal approval.

    (b) (Blank).

(Source: P.A. 97-74, eff. 6-30-11; 98-104, eff. 7-22-13.)

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Last modified: February 18, 2015