Co-Payments

A co-payment is collected when an office visit service is rendered.  Generally, co-payments are applied to evaluation and management services, which include office visit and exams performed in the physician's office.  Our reimbursement excludes the co-payment that the physician collects from the member.

Exceptions

Do NOT collect the co-payment when services occur without a separate identifiable office visit, as in the case of: 

• Allergy injections
• Pediatric and adult immunizations
• Lab or blood draws
• Surgical procedures

TVHP waives the co-payment for the following office visit services:

• Well-Child care

• Well-Women care
• Immediate pre- and post-op office visits (these services are included in the payment for the surgical procedure)
• Physician services for all maternity care including prenatal and post natal visits (except for managed care plans, where only one co-payment is applied)

Health Care Debit Cards

Some members use HealthCare Debit Cards to cover out-of-pocket costs.  HealthCare Debit Cards typically have a major debit card logo. 

When to use a Health Care Debit Card

The debit card should only be used to collect co-payments or outstanding balances on billing statements (after BCBSVT has processed the claim).  The card should not be used to process the full charge up front.