What is a Provider Fee?

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

The provider fees are:

  • $0 for Telemedicine.
  • $50 for each primary care visit.
  • $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 PRA and are paid even if the member has met its 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.