$30 Copay After Deductible
Posted : admin On 1/29/2022Let’s say your plan has a $0 deductible, a $30 copayment for doctor’s visits, and a 30% coinsurance for every other service. You’ll end up paying about $71 out-of-pocket for the hearing test: $30 for the visit and $40.80 for the hearing test. This is a simple calculation, however, that may not account for all of the complexity of your plan. $30 copay; $40 copay: After annual medical deductible, plan pays 70%: After annual medical deductible, plan pays 70%: Annual Out-Of-Pocket Max: $1,000 per person; $2,800 per family: $3,500 per person: $3,450 per person: Routine Physical Exams And Immunizations. Plan pays 100%, no copay: Not Covered: Plan pays 100%, no copay: Routine. What does $45 co-pay deductible waived mean? I want to understand my insurance. I have a $2000 deductible and a $5000 maximum out of pocket. I understand that I would have to pay $2000 before insurance starts kicking in, but under drs. Visits it says $45/visit (deductible waived). What does that mean? $30 Copay Primary Care Physician $30 Copay Convenient Care Center $30 Copay Specialist $65 Copay. Emergency Urgent Care Center $75 Copay Hospital $400 Copay after Deductible TIP: For non-emergency care, a Convenient Care or Urgent Care Center should be able to provide services at a lower cost.

Compare your medical plan options
For 2021, you can choose from two CareFirst BlueCross BlueShield plans—the CareFirst PPO Plan and the CareFirst Health Reimbursement Arrangement (HRA) Plan.
With the CareFirst PPO you’ll pay a bit more for coverage per paycheck but will generally pay less out-of-pocket for office visits. This plan may be a good choice if you know you’ll have lots of doctor visits.
With the CareFirst HRA plan, you’ll pay less per paycheck for coverage, but generally pay a bit more out-of-pocket when you see a doctor or other healthcare provider. This plan also has a higher deductible . However, you will receive money from Sodexo in your HRA to help pay down your deductible. The money in the HRA account will help pay for prescriptions and other healthcare costs. This plan provides out-of-network coverage which allows you and your family members to seek treatment from any provider of your choice and pay a bit more out-of-pocket. Tip: You will pay the least for care when you see in-network providers
You may view the Summary Plan Descriptions (SPDs) and Summary of Benefits and Coverage (SBCs) for these plans on SodexoBenefitsCenter.


This new benefit from Carrum Health connects CareFirst members facing orthopedic surgery (knee, hip, elbow, spine or shoulder) with high-quality surgeons and expert guidance. All surgery costs and most travel expenses, if necessary, will be covered.

Take a Closer Look at Each Plan (In-network Coverage only)

What Does $40 Copay After Deductible Mean
CareFirst PPO Plan | CareFirst HRA Plan | ||
---|---|---|---|
Annual Deductible | |||
You | $1,000 | $1,750 | |
You + Spouse/Partner | $2,000 | $3,500 | |
You + Child(ren) | $2,000 | $4,175 | |
Family | $2,000 | $4,500 | |
Money from Sodexo (only for HRA plan) | |||
You | No plan account | $750 | |
You + Spouse/Partner | No plan account | $1,175 | |
You + Child(ren) | No plan account | $1,175 | |
Family | No plan account | $1,500 | |
Copays and Coinsurance | |||
Preventive Care | $0 (no deductible) | $0 (no deductible) | |
Primary Care Office Visit | $30 copay | 20% after deductible | |
Specialist Office Visit | $40 copay | 20% after deductible | |
Physical, Speech and Occupational Therapy Visits | $15 copay | $15 copay | |
Video Visit | $0 Urgent care, cost varies for other services | $0 Urgent care, cost varies for other services | |
Urgent Care | $30 copay | 20% after deductible | |
Emergency Room | $150 copay (waived if admitted) then 30% after deductible | 20% after deductible | |
Hospital Coverage | $250 copay, then 30% after deductible | 20% after deductible | |
Most Other Services | 30% after deductible | 20% after deductible | |
Out-of-Pocket Maximum | |||
Individual | $5,000 | $6,350 | |
Family | $12,700 | $12,700 |
$30 Copay After Deductible
Copays for High Deductible Health Plans (HDHPs) work a little different from other types of plans. Typically with HDHPs, employees must meet their deductible before the carrier will pay for any services other than preventative care.
$50 Copay After Deductible
This means that if you have an HDHP with a $3,000 deductible and a $20 copay for primary care, you may have to meet the entire deductible before the copay will apply. This is why HDHPs are often paired with HSAs - the pretax contributions help offset the $3,000 deductible amount that you'll pay out-of-pocket before your copay can apply.