Medicaid Copays – Get Care

Patients have the right to receive care and medicine even if they can’t pay the copay

As pharmacists and pharmacy technicians in North Carolina, it’s crucial to inform our patients about their rights, especially when it comes to accessing care and medicine. One key aspect that often causes confusion is the health insurance copay.

Patient Right to Care Even Without Copay

In North Carolina, denying care or prescriptions due to an unpaid copay is not permitted. There are regulations to ensure that financial constraints do not prevent patients from accessing medical services or medications. If a patient can’t pay their $4 copay immediately, healthcare providers, including doctors and pharmacies, are still required to provide the needed services or medications. 

In North Carolina, denying care or prescriptions due to an unpaid copay is not permitted. There are regulations to ensure that financial constraints do not prevent patients from accessing medical services or medications. If a patient can’t pay their $4 copay immediately, healthcare providers, including doctors and pharmacies, are still required to provide the needed services or medications. 

For patients who are confused or need more information about how this system works, there are several resources available:

These resources can help patients understand their rights and navigate the Medicaid system effectively.

As pharmacists and pharmacy technicians, you play a vital role in educating our patients about their rights and helping them access care. By understanding the rules around copays and the resources available, we can better assist our patients in navigating their healthcare options. Remember, no one should be denied care or medicine because they can’t pay a copay upfront.

Do you have questions about this regulation? Contact the N.C. Medicaid Provider Ombudsman. Call 866-304-7062 from 8 a.m. to 5 p.m., Monday through Friday, or visit Medicaid.ProviderOmbudsman@dhhs.nc.gov.

Has a doctor or pharmacy refused to provide service or fill prescriptions because you could not pay the Medicaid copay? Free help is available across North Carolina. Request legal assistance and learn about your rights

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