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Does my patient need to pay a co-pay?

Rather than a co-pay, Impact members will pay a provider fee at the time of service.

A Provider Fee is an amount paid by the member to a healthcare provider at each visit.

The provider fees are:

  • $0 for Telehealth.
  • $50 for each primary care visit.
  • $50 for each Allergy Test/Serum Injection.
  • $75 for each specialist or urgent care visit.
  • $150 for emergency room or in-hospital visits.

These fees are not applied to the member's Primary Responsibility Amount (PRA), similar to a deductible, and are paid even if the member has met his or her PRA for the year. For eligible services, the Provider Fee is applied, then any remaining PRA and finally the Co-Share is applied up to the Co-Share limit.

For more details on healthcare sharing-specific terms, see the Glossary of Terms here.