Copayments, Deductibles and Co-insurance

Create an account or login to MyBlue to see the status of your deductible (if you have one). Your most recent Explanation of Benefits also shows deductible amounts met for the current year. Please contact Member Service at the number on the front of your ID card if you have questions about your deductible.

Your copayments for medical services are shown at the bottom of your ID card.

If you have a pharmacy benefit, you will need to identify your pharmacy benefit administrator in order to determine your copayment for each medication you receive. The name of your pharmacy benefit administrator (e.g., Express Scripts, Inc.) is printed on the back of your member ID card on the bottom of the card. To obtain your copayment amount, you can present this information to your pharmacist or log in to your Member Central account, and then click Review Your Benefits.

If your pharmacy benefit administrator is not displayed on the back of your ID card, you can contact your employer for this information or call Member Service at the number on the front of your ID card.

Your copayments are usually a fixed dollar amount (for example, $10, $20, or $30) you pay each time you use a particular medical service or fill a prescription. Copayments are usually due at the time you have an office visit or fill a prescription.

Medical services that may have copayments, include:

  • Office visits
  • Mental health provider visits
  • Emergency room visits

Create an account or login to MyBlue for detailed information about your benefits.

Also known as cost-sharing, co-insurance is the portion of eligible expenses that plan members are responsible for paying, typically after the deductible is met. Co-insurance is usually a percentage of the provider's actual charge, or the allowed amount.