Specialist Copay



Two rewards you can earn:

  1. Free PCP visits:
    • To earn free PCP visits, select a PCP, and
    • Complete the RealAge® test (an online health assessment that helps you determine the physical age of your body compared to your calendar age.)
  2. $5 reduction to your specialist copay:
    • To receive a $5 reduction in your specialist copay, complete one of the recommended screenings listed in the State of Maryland Wellness Plan Activities (PDF).

The $5 reduction to your specialist copay will be activated after CareFirst receives a verified paid claim. The claim must meet certain requirements including having gone through the CareFirst claims review process and have been paid. CareFirst will update the member's account to show the $5 copay reduction has been granted. The entire process may take up to 45 days.

For example, you may have to pay a $20 copay every time you see your primary care doctor. Seeing a specialist may require a higher, predetermined copay. Another cost-sharing consideration is known.

Almost all private insurance policies require the insured person to pay a co-pay when visiting a doctor or any other health care provider. The co-payment amount varies depending on the insurance plan. Typical co-pays for a visit to a primary care physician range from $15 to $25. Co-pays for a specialist will generally be between $30 and $50. The amount of the copay can change depending on where you go. You may have a $30 copay for a primary care doctor visit. A specialist visit may take a $50 copay. A trip to the ER could be as much as a $200 copay. You can go to any CPP Specialist, Chiropractor, Speech or Occupational Therapist to receive a copay reduction. To qualify for the $0 CPP PCP copay, you must have selected a CPP PCP which appears on your State Health Plan ID card and then see that PCP for your office visit. Co-Pay Relief – Patient Advocate Foundation Co-Pay Relief. Patient Advocate Foundation (PAF) programs and services are fully operational. As the Coronavirus spreads across the country, PAF wants to make sure you have answers and resources to support you during this uncertain and stressful time. For resource, FAQ’s.

To access the above activities, simply log in to your Sharecare account, click Achieve, then Rewards. Next, click State of Maryland Wellness Program 2021. The sooner you complete your wellness plan activities, the sooner you start saving. If you require assistance with the wellness program or completing any activity, call Sharecare at 877-260-3253.

Specialist copay assistance

Specialist Copay Definition

*Sharecare, Inc. is an independent company that provides health improvement management services to CareFirst members. Sharecare, Inc. does not provide CareFirst BlueCross BlueShield products or services and is solely responsible for the health improvement management services it provides.