The Copay Plan

With the Blue Shield Copay Plan, you control the costs of your health care. You can choose the $25, $35, or $45 plan, and will have no plan deductible to meet when you receive covered services from Blue Shield Preferred Providers.

As a Copay Plan member, each and every time you seek medical care, you choose your own providers. For office visits and many other services with Preferred Physicians, you pay just your fixed $25, $35, or $45 Copay. For most other services with Preferred Providers, you pay a fixed dollar Copay or a percentage copayment of 20%, 30%, or 40%. Your level of copayment is determined by the plan you have chosen (see page 2 for a chart of plan options).

You will receive benefits for all the plan’s covered services without having to meet any plan deductible as long as you use Preferred Providers. When you use Non-Preferred Providers, your plan benefits will be subject to a $250 per person or $500 per family plan deductible.

Before you meet this deductible, the amount you pay to Non-Preferred Providers for covered services, up to Blue Shield’s Allowable Amount, will count toward your plan deductible. Payments in excess of Allowable Amounts will not count toward the deductible.

Remember, you can avoid paying even one dollar toward this Non-Preferred Provider deductible — but it will be your responsibility to make sure the providers you use are Preferred Providers.

Plan Highlights