{"data":{"id":"us/42-cfr-457.515","jurisdiction":"us","citation":"42 CFR 457.515","heading":"Co-payments, coinsurance, deductibles, or similar cost-sharing charges: State plan requirements.","body":"To impose copayments, coinsurance, deductibles or similar charges on enrollees, the State plan must describe—\n(a) The service for which the charge is imposed;\n(b) The amount of the charge;\n(c) The group or groups of enrollees that may be subject to the cost-sharing charge;\n(d) The consequences for an enrollee who does not pay a charge, and the disenrollment protections adopted by the State in accordance with § 457.570;\n(e) The methodology used to ensure that total cost-sharing liability for a family does not exceed the cumulative cost-sharing maximum specified in § 457.560; and\n(f) An assurance that enrollees will not be held liable for cost-sharing amounts for emergency services that are provided at a facility that does not participate in the enrollee's managed care network beyond the copayment amounts specified in the State plan for emergency services as defined in § 457.10.","path":["Title 42—Public Health","CHAPTER IV—CENTERS FOR MEDICARE \u0026 MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES","SUBCHAPTER D—STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs)","PART 457—ALLOTMENTS AND GRANTS TO STATES","Subpart E—State Plan Requirements: Enrollee Financial Responsibilities"],"source_url":"https://www.ecfr.gov/api/versioner/v1/full/2026-08-25/title-42.xml","current_through":"2026-08-25","vintage":"","retrieved_at":"2026-08-27T02:26:11Z","sha256":"ece7c9adfc5934fbee069bda27f1b39bb1fbd3e26a628a193b5d4c7d3a2e839e","source_id":"us-cfr","stale":true,"prev":"us/42-cfr-457.510","next":"us/42-cfr-457.520"},"notice":"GroundRules: Original legal text. Not legal advice."}