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  
(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.