Co-Pays

For Medication Prescriptions and Dental Benefits, members must share in the cost of the service provided. (Copays are waived during the COVID-19 state of emergency).

This is a Copayment (or copay), or a set amount members pay when they receive a service.

Please refer to your Member Handbook for complete information about copays.

You can find your copays on your member ID card.

Paying Copays and other Payments

• You must make copays directly to providers at the time of service.
• You may be responsible for paying for non-covered services if you sign a release agreeing to pay before services are received. Note, the cost of non-covered services is likely to be more than a copay for a covered service.

Exemptions

These types of members are always exempt from copays:

1. Children under the age of 21
2. Pregnant women, including the post-partum period (90 days)
3. Chronic Renal Disease Program (CRDP) members
4. Long-term care nursing facility group or the acute care hospital group