Blue Cross Blue Shield Specialist Copay



Not all health care services are created equal. A routine visit to your family doctor’s office is much different than a trip to a specialist, so it makes sense that they wouldn’t cost the same. Our plans with tiered copays connect the amount you pay to the type of care you receive.

You may also have a copay after you pay your deductible, and when you owe coinsurance. Your Blue Cross ID card may list copays for some visits. You can also log in to your account, or register for one, on our website or using the mobile app to see your plan’s copays. Co-pay Option - Separate Medical and Prescription Drug Deductible.Services include certain Specialty Services which are Ambulatory Services performed in a non-hospital setting approved and designated by Blue Cross & Blue Shield of Mississippi.

What does this mean for me?

If your plan offers tiered copays, you’ll find a few kinds of payments when you pay for your health care. The lowest copays will be for office visits to a primary care physician, physician’s assistant or nurse practitioner. If you need to visit urgent care or see a specialist like a cardiologist or an immunologist, your copay will be a little higher. The most expensive copays will come when you visit the emergency room.

What primary care physicians and practitioners are in the lowest tier of copays?

There are many doctors and practitioners with a primary care specialty. An office visit to any of the following kinds of health care professionals will be in the lowest tier of copays:

Family practice

  • Adolescent medicine
  • Family practice
  • Geriatric medicine – Family practice
  • General practice
  • Family nurse practitioner
  • Preventive medicine
Blue Cross Blue Shield Specialist Copay

General practice

  • Adolescent medicine
  • Family practice
  • General practice
  • Public health / General preventive medicine
  • Preventive medicine

Geriatric medicine

  • Geriatric medicine – Family practice
  • Geriatric medicine – Internal medicine

Internal medicine

  • Adolescent medicine
  • Geriatric medicine – Internal medicine
  • Internal medicine
  • Internal medicine – Pediatrics

Obstetrics and gynecology

  • Obstetrics and gynecology
  • OB/GYN nurse practitioner

Pediatrics

  • Adolescent medicine
  • Pediatrics
  • Pediatric nurse practitioner

Nurse practitioner

  • Certified nurse practitioner
  • Family nurse practitioner
  • OB/GYN nurse practitioner
  • Pediatric nurse practitioner

Physician assistant

  • All provider specialties

Tiered copays are not available for all Blue Cross Blue Shield of Michigan health plans. Check your plan riders or call the phone number on the back of your member ID card to find out if your plan has tiered copays.

Blue Cross Blue Shield Specialist Copay Guide

Maintenance Notification:
Blue Access for Members and quoting tools will be unavailable from 3am - 6am on Saturday, October 20.
We apologize for any inconvenience.

Maintenance Notification:
Blue Access for Members and quoting tools will be unavailable from 2am - 5am Saturday, October 20.
We apologize for any inconvenience.

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