An office visit copayment is available under Select Coverage and only applies to the following network primary care services: Family Practice, General Practice, Gynecology, Internal Medicine, Pediatric Medicine, including Nurse Practitioner, Physician Assistant and Registered Dietitian. Copayments apply to the provider's office visit charge only and are not subject to the deductible or coinsurance requirements. Charges for services rendered in the provider's office such as lab work and x-rays are applied a 20 percent coinsurance, not subject to the deductible. Lab work and other tests performed outside the provider's office are subject to regular Plan benefits. Out-of-network provider office visits are subject to the normal out-of-network deductibles and coinsurance rates.
Helpful Tip: Allowable Charges
When you see a network provider, they won't charge you more than the Plan's allowable amount for covered services. This helps control your out-of-pocket expenses.