The office visit copay is a set dollar amount (e.g. $15 per visit) that is typically due at the time of your visit.

  • High Deductible Health Plan participants: You will pay the full cost of the visit prior to meeting your deductible. Once your deductible is met, you will pay the office copay amount.
  • The office visit copay covers the office visit only, and does not cover any additional services you might receive during your visit (e.g. lab work or X-rays).
  • Additional services are subject to your deductible and coinsurance, until you reach your out-of-pocket limit.

You will not pay copays for preventive care office visits.

Examples of Office Visits Types and Copay Amounts

Office Visit Type $15 Primary Care Visit $25 Specialty Visit
Family Practice ✔  
General Practice ✔  
Internal Medicine ✔  
Gynecology/OB ✔  
Midwives
(if your plan provides in-network midwives)		 ✔  
Nurse Practitioners ✔  
Physician Assistant ✔  
Pediatrics ✔  
Urgent Care   ✔
Chiropractic ✔  
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.