{"data":{"id":"us-il/215-ilcs-106-30","jurisdiction":"us-il","citation":"215 ILCS 106/30","heading":"Cost sharing.","body":"(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:\n(1) There shall be no co-payment required for well-baby or well-child care, including age-appropriate immunizations as required under federal law.\n(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:\n(A) $15 per month for one family member.\n(B) $25 per month for 2 family members.\n(C) $30 per month for 3 family members.\n(D) $35 per month for 4 family members.\n(E) $40 per month for 5 or more family members.\n(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.\n(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:\n(A) $5 for medical visits.\n(B) $3 for generic prescriptions and $5 for brand name prescriptions.\n(C) $25 for emergency room use for a non-emergency situation as defined by the Department by rule.\n(5) (Blank).\n(6) Co-payments shall be maximized to the extent permitted by federal law and are subject to federal approval.\n(b) (Blank).","path":["CHAPTER 215 INSURANCE","Children's Health Insurance Program Act."],"source_url":"https://www.ilga.gov/legislation/ILCS/details?ActID=1255\u0026ChapterID=22\u0026ChapAct=FullText\u0026Print=True","current_through":"at least Public Act 104-790","vintage":"","retrieved_at":"2026-09-15T04:46:30Z","sha256":"b4714b03487a35e8d06f15ee3d26ffb1acf98693d5be308b06751cdc219a1045","source_id":"us-il","stale":false,"prev":"us-il/215-ilcs-106-26","next":"us-il/215-ilcs-106-31"},"notice":"GroundRules: Original legal text. Not legal advice."}