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This document outlines the standards and procedures for inmate medical co-payment fees within the Massachusetts Department of Correction, including definitions, general provisions, fee structures,
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How to fill out inmate medical co-payments

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How to fill out INMATE MEDICAL CO-PAYMENTS

01
Obtain the INMATE MEDICAL CO-PAYMENT form from the facility's medical department.
02
Provide your personal identification information at the top of the form, including your name, inmate number, and facility location.
03
Fill out the details in the medical service requested section, specifying the type of medical attention required.
04
Indicate the date of your medical visit or when you anticipate needing the medical service.
05
Review the co-payment amounts and indicate your acknowledgment of the fees associated with the medical services.
06
Sign and date the form to certify that the information provided is accurate and to consent to the co-payment agreement.
07
Submit the completed form to the medical department or designated staff member as instructed.

Who needs INMATE MEDICAL CO-PAYMENTS?

01
Inmates who require medical services while incarcerated and are responsible for their medical expenses in accordance with facility policies.
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Inmate medical co-payments are charges that inmates must pay for certain medical services while incarcerated, aimed at reducing unnecessary healthcare usage.
Inmates who seek non-emergency medical care while in a correctional facility are required to file inmate medical co-payments.
Inmates must complete a designated form provided by the facility, detailing the medical service requested and any relevant personal information.
The purpose of inmate medical co-payments is to manage healthcare costs, encourage inmates to utilize medical services responsibly, and promote personal accountability.
The information reported should include the inmate's name, identification number, type of medical service requested, and the date of the request.
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