Verify Copayments

Provider Type

  • Physicians
  • Participating Physician Groups (PPG)
  • Hospitals
  • Ancillary

Most Medicare Advantage (MA) plans require a member copayment for covered services or supplies. Member copayment amounts vary by plan, county and type of service.

To ensure accurate collection of copayments, providers should refer to the member's Evidence of Coverage (EOC) or the Schedule of Benefits or Summary of Benefits for specific services and applicable copayment amounts. The Schedule of Benefits is available on the provider portal website.