$30 Copay After Deductible

This is a comparison of the copay medical plans for FY 2019-20 open enrollment. Please see the High Deductible Health Plan Comparison page as well.

  1. $50 Copay After Deductible
Comparing network costs versus non-network costs between Kaiser Permanente and United Healthcare in the Co-Pay plans
United Healthcare (UHC) Copay Choice Plus PlanKaiser Permanente (KP) DHMO Plan
Annual DeductibleNetworkNon-NetworkAnnual DeductibleNetworkNon-Network
Individual$1,500$3,000Individual$750Not Covered
Family $3,000$6,000Family $1,500
Out of Pocket Max Comparison
Annual Out-of-Pocket Max: UHCAnnual Out-of-Pocket Max: KP
Annual DeductibleNetworkNon-NetworkAnnual DeductibleNetworkNon-Network
Individual$5,000$10,000Individual$2,000Not Covered
Family$10,000$20,000Family $4,000

Copays are typically charged after a deductible has already been met. In some cases, though, copays are applied immediately. Suppose a patient has a health insurance plan with a $30 copay to. Yes, if your deductible is $5,000 or whatever, you would have to meet that before your copay becomes $30. Copays are typically charged after a deductible has already been met. In some cases, though, copays are applied immediately. Suppose a patient has a health insurance plan with a $30 copay to. Let’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% coinsurance after deductible Not Covered Requires preauthorization for certain services, failure to obtain preauthorization may result in denial of benefits. Limited to plan requirements.See Section 3(e). Hospice services $60 copay after deductible/day 40% coinsurance after deductible in an inpatient setting.

Co-Insurance Comparison
Co-Insurance: UHCCo-Insurance: KP
Annual DeductibleNetworkNon-NetworkAnnual DeductibleNetworkNon-Network
Percentage you pay after you have satisfied your deductible.20%50%Percentage you pay after you have satisfied your deductible.10%Not Covered
After
Office Visit and Urgent Care Cost Comparison
Office Visits/Urgent Care (1): UHCOffice Visits/Urgent Care (1): KP
ServiceNetworkNon-NetworkServiceNetworkNon-Network
Preventative Care/ScreeningsNo Charge50% of eligible expenses after deductiblePreventative Care/ScreeningsNo ChargeNot Covered
Primary Care - Illness/Injury$30 CopayPrimary Care - Illness/Injury$30 Copay
Specialist$50 CopaySpecialist$50 Copay
Inpatient Hospital20% Co-insurance after $1,000 CopayInpatient Hospital10% Coinsurance
Urgent Care$75 CopayUrgent Care$75 Copay
Ambulance20% after deductibleAmbulance$500 Copay
Emergency Room$500 CopayEmergency Room
Virtual Visits
(Network Benefits are available only when services are delivered through a
Designated Virtual Network Provider.)
$30 CopayNot CoveredVirtual Care - Primary/Specialty
- Phone Visit, Video Visit
- Chat Online, Email, E-visits
No ChargeNot Covered
Mental Health Benefits Comparison
Mental Health (1): UHCMental Health (1): KP
ServiceNetworkNon-NetworkServiceNetworkNon-Network
Inpatient (Hospitalization/Day Treatment)20% Co-insurance after $1,000 Copay50% of eligible expenses after deductibleInpatient (Hospitalization/Day Treatment)10% Coinsurance Not Covered
Outpatient (Therapy)$30 CopayOutpatient (Therapy)$30 Copay
Inpatient and Outpatient Addictive Disorders Services Comparison
Substance-Related & Addictive Disorders Services (1): UHCSubstance-Related & Addictive Disorders Services (1): KP
ServiceNetworkNon-NetworkServiceNetworkNon-Network
Inpatient20% Co-insurance after $1,000 Copay50% of eligible expenses after deductibleInpatient10% Coinsurance Not Covered
Outpatient (Therapy) $30 Copay Outpatient (Therapy)$30 Copay
Vision Benefits Comparison
Vision: UHCVision: KP
ServiceNetworkNon-NetworkServicePediatric
(up to end of month he/she turns age 19)
Adult
(members age 19 and over)
Up to 1 Routine Exam per plan year under the Medical Plan$50 Copay- Allowances apply to network providers only.
- Please refer to your plan details for out-of-network allowances
Optometrist/
Ophthalmologist
Optometrist: $30 Copay/ Ophthalmologist: $50 Copay
(Includes contact lens fitting up to $175)
Optical hardware - Frames $130 allowance OR
- Contact lens $150 allowance
Optical hardware- 10% Coinsurance
- 1 pair of glasses & lenses every 2 years or 2 years of contact lenses
$150 Credit once every 24 months towards optical hardware
Prescription Comparison
Prescription: UHCPrescription: KP (2)
Retail: 30-day supplyMail Order: 90-day supplyRetail: 30-day supplyMail Order: 90-day supply
Tier 1$10 Copay$20 CopayGeneric$10 Copay$20 Copay
Tier 2$30 Copay$60 CopayPreferred Brand Name$30 Copay$60 Copay
Tier 3$50 Copay$100 CopayNon-Preferred Brand NameApproved drugs covered at generic costshare
Specialty (30 day supply)20% up to $100Specialty20% up to $100

Myst iv: revelation download for mac. * Please refer to the official plan documents for detailed information and listing of covered services

  1. If a procedure is preformed during a Primary Care, Specialty Care, or Urgent Care Visit then the service is covered at coinsurance after deductible is met.
  2. For Southern Colorado Kaiser Permanente members: maintenance medications must be filled at a Pharmacy in a Kaiser Permanente medical office or through Kaiser Permanente mail order.

Rates - Employee Monthly Contribution

$50 Copay After Deductible

United Healthcare Copay Choice Plus PlanKaiser Permanente DHMO Plan
Employee Only$159.14Employee Only$93.72
Employee + Spouse$437.52Employee + Spouse$298.02
Employee + Child(ren)$310.30Employee + Child(ren)$190.34
Family$638.86Family$440.48