A copayment (or copay) is a fixed amount you pay for a covered health care service. The amount can vary by the type of covered health care service. Blue Copay is designed with a variety of copays built into the plan to help lower the amount of your health insurance premium. Blue Copay is comprehensive, reliable and affordable. Your coverage includes hospital, surgical, medical, accident and maternity care – and all with no deductible and no coinsurance.
Benefit Summary (Benefits include but are not limited to:)
Office Visit & Services
Your Primary care office visit copay is $30.
Your Specialist office visit copay is $80.
Services listed below are subject to appropriate copays.
Paid at 100 percent of the allowable charge. Includes routine screenings, immunizations, checkups and counseling received to prevent illness or disease.
Your dependents are covered to age 26.
The BlueRx CardSM prescription drug program provides savings using a four-tiered benefit. (If generics are available for a prescription, they must be used.) Copay is $15 for generic drugs, $50 for formulary brand drugs, $75 for non-formulary brand drugs and $150 for specialty drugs. Mail order drugs have a copay of 2 ½ times the retail copay.
With Blue Copay, each person covered has an unlimited lifetime maximum benefit.
Deductibles and Coinsurance
Blue Copay plan uses a variety of copays in place of deductibles and coinsurance.
Covered Services include:
See the Exclusions page for details.
Additional Program Information
Triple Option Plan
The Triple Option Plan is available to large groups with this product. The plan offers employees one of three out-of-pocket choices annually within the Blue Copay benefit program. The employer must contribute at least 25 percent of the employee-only premium amount for the highest out-of-pocket option. This stabilizes the group's base and gives the employees the option to "buy up" to a better level of coverage, based on their personal insurance needs.
Contact us to learn more about the features of Blue Copay.