Section 2000, Copayment Schedule

Section 2000, Copayment Schedule Anonymous (not verified) Thu, 09/15/2016 - 08:07
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Revision 21-1; Effective March 5, 2021

 

To determine the individual’s copayment percentage, refer to the following copayment schedule. The copayment schedule is based on paying a copayment when the income limit exceeds 300 percent of Supplemental Security Income.

Copayment Schedule
Net Monthly Income From Net Monthly Income To Net Monthly Income Percentage
$ 0 $ 2,382.00 0%
$ 2,382.01 $ 2,679.75 3%
$ 2,679.76 $ 2,779.00 5%
$ 2,779.01 $ 3,176.00 7%
$ 3,176.01 $ 3,573.00 9%
$ 3,573.01 $ 3,970.00 12%
$ 3,970.01 $ 4,366.99 15%
$ 4,367.00 $ 4,763.99 20%
$ 4,764.00 $ 5,160.99 30%
$ 5,161.00 $ 5,557.99 40%
$ 5,558.00 $ 5,954.99 50%
$ 5,955.00 $ 6,550.49 60%
$ 6,550.50 $ 7,145.99 70%
$ 7,146.00 $ 7,939.98 80%
$ 7,939.99 $ 8,733.98 90%
$ 8,733.99 Higher 100%