First Medical Vital

PO Box 195079, San Juan, PR 00919-5079
|
1-844-347-7800

BiggerIncrease fontSmaller Decrease font

Bigger Increase fontSmaller  Decrease font

Increase font Decrease font

Co-payments

Will I have to pay to get health care services?

Sometimes you will have to pay to get health care services. Preventive care is care that helps you stay well, like exams, shots, pregnancy care, and childbirth. This kind of care is always free. You don’t have copays for preventive care.

For other care like hospital stays or sick child visits, it is possible that you may have to pay part of the cost. Copays are what you pay for each health care service you get.

Not everyone in the Vital Plan has copays. Your Vital Plan card will tell you if you have copays and what they are. Copays depend on the type of Vital Plan coverage you have. Your Vital Plan card says what type of coverage the Vital Plan has.

None of your doctors or providers can refuse to give you medically necessary services because you don’t pay your copays. But, First Medical and your providers can take steps to collect any copays you owe.

You should only have to pay your copay for your care. You should not be received billed for the rest of the cost of your care. If you receive billed for the rest of the cost, you can appeal. Look at Part 7 of your Beneficiary Manual to find out what to do if you get a bill for your care.

Copay Charts

Do you have to pay copays for a PCP, Specialist, ER visit, hospital stay, or other type of service? Not sure? Check the chart below, look at your membership card or call First Medical at 1-844-347-7800; TTY/TDD users should call 1-844-347-7805.

Tabla-de-copago-ingles_

* Copays apply to diagnostic tests only.  Copays do not apply to tests required as part of a preventive service.

** Copays apply to each medicine included in the same prescription pad.