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 cost you must pay to receive a covered benefit at the time of 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