October 7, 2015

Copayments and Deductibles in Medicaid and Other Health Insurance Plans

OLR Report 2015-R-0160 provides information on copayments and deductibles for Medicaid, state employee medical plans, and other private health insurance plans. It also includes general income limits for eligibility for Connecticut’s Medicaid-funded health care programs.

Both deductibles and copayments are out-of-pocket payments made by policyholders. However, a deductible is paid before insurance coverage begins and a copayment is paid each time someone receives a specific health care service. Deductibles and copayments are both common forms of health insurance cost sharing and the payments vary depending on which health insurance plan an insured has.

Husky A and D Medicaid income limits and eligibility are based on family size and deductibles and copayments are not required. Husky C provides coverage for individuals who are elderly, blind, or living with a disability.  Monthly income is also used to determine eligibility.

For current Medicaid income limits and additional information concerning out-of-pocket costs for the plans referenced above, read the full report.