How Doctor Visit Copays Work With COBRA Coverage

  1. Knowledge Base
  2. Starting COBRA
  3. Copays & Routine Doctor Visits
What should I expect to pay for doctor visit copays if I continue my employer’s health plan through COBRA?

Copay amounts under COBRA are the same as they were when you were actively employed. Because COBRA continues your existing group health plan, the plan’s rules for copays, deductibles, and coinsurance do not change. The only difference is how the premium is paid; the structure of your benefits remains the same.

What You Need to Know

  • Copays do not change: The amount you pay for doctor visits under COBRA is the same as it was while you were employed, because the same group health plan continues
  • Plan rules still apply: Requirements for primary care, specialist visits, prescriptions, deductibles, and coinsurance remain in effect without adjustment under COBRA
  • Year-to-date amounts carry over: Payments you already made toward your deductible or out-of-pocket maximum continue to count for the plan year when you move to COBRA coverage.