Copay Tips

  • You are typically required to pay your copay to your doctor’s office at the time of your visit
  • The office visit copay is a set dollar amount (e.g. $15 per visit)
  • Your deductible may not apply, depending on your health plan design

You will not pay copays for preventive care office visits. Copays are for the office visit only, and do not cover any additional services you might receive during your visit (e.g. lab work or X-rays). Any additional services are subject to your deductible and coinsurance, until you reach your out-of-pocket limit. Here are examples of office visit types and the applicable copays.

Office Visit Type

$15 Primary Care Visit

$25 Specialty Visit

Family Practice


General Practice


Internal Medicine




(if your plan provides in-network midwives)


Nurse Practitioners


Physician Assistant




Urgent Care




Home Health Visit

Subject to deductible and coinsurance

Subject to deductible and coinsurance

Palliative Care Visit

For PCP Only

For Specialist Only

Vision Exam


Pre/Postnatal Visits

For family practice with obstetrics or OB/GYN

For maternal/fetal specialist

Mental Health Visits/Therapy


Physical Therapy


Occupational Therapy


Speech Therapy


Other Practitioner



*If all prenatal visits are billed as a package at the end of pregnancy, then your deductible and 10% coinsurance apply. Check with your doctor’s office for more information.