PM 06-08-01-c

When an application is approved for All Kids/FamilyCare Share or Premium Level 1, Information Regarding Copayments (Form 3726A) and All Kids/FamilyCare Copay Tracking Form (Form 3726) are sent to the family to keep track of their copays.

  1. (All Kids Unit) Receives Form 3726A from the family.
  2. (All Kids Unit) Determines if the copay cap is met.
    1. (All Kids Unit) If met, processes a TA 31/TAR 20. The day after the copay is met is entered in the PERSONS field following Item 80 code 185.

      (System) Sends Notice Regarding Copays (Form 3708) to the family. 

    2. (All Kids Unit) If not met, manually completes and sends Notice Regarding Your Copay (Form 3708A) to the family.
  3. (System) Once the copay cap is met, changes the message on the medical card to indicate that copays may not be charged.
  4. (System) At renewal, resets the copay met indicator to unmet for the next 12-month eligibility period.

All Kids Premium Level 2

revised textHFS' MMIS system tracks out of pocket hospital service expenses for children enrolled in Premium Level 2. Copayments are tracked per child by plan year (July through June). Every year on July 1, HFS resets the copay tracking to zero for the next plan year.

If an All Kids Premium Level 2 case is recalculated for Premium Level 1 and the copay maximum was met for at least one child, the All Kids Unit updates the copay met indicator code 185 to show the copay cap has been met.