Members Who Don't Have to Pay Copayments

You don't need to pay a copayment for your prescription drugs if you:

  • Are under 21 years of age
  • Are enrolled in MassHealth because you were in the care and custody of the Department of Children and Families (DCF) when you turned 18 and you continue to have MassHealth
  • Are pregnant, or your pregnancy ended fewer than 60 days ago
  • Are a patient in a nursing facility; chronic-disease, acute or rehabilitation hospital; or intermediate-care facility for the developmentally delayed
  • Are receiving hospice care
  • Are an American Indian who is currently receiving, or has ever received, an item or service furnished by the Indian Health Service, an Indian tribe, a tribal organization or an urban Indian organization, or through referral, in accordance with federal law
  • Have already met the copayment cap for the current calendar year (January 1 – December 31), unless your eligibility changes

Be sure to tell the pharmacist if you don't need to pay a copayment when you drop off your prescription — especially if you are pregnant.