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CopayGo Health Plan

Last Updated: Tuesday, September 30, 2025

What is CopayGo?

CopayGo is a new Highmark health plan that features a national two-tiered network. CopayGo is a copay-only plan with no deductible or coinsurance. Digital tools in the MyHighmark member portal will offer greater cost and quality transparency.

Providers are designated "Enhanced" or "Standard" based on rankings determined by the Blue Cross Blue Shield Axis^® Provider Insights, a national dataset that measures quality, appropriateness of care and cost/efficiency at the individual provider level.

List of Enhanced and Standard Providers

The list below includes individual National Provider Identifier (NPI) numbers and names of providers indicating designation as Enhanced or Standard.

2026 List of Providers

How do I know what copay to take at the time of service?

To get the information you need to take the correct copay at the point of service:

Submit a 270 inquiry, OR search the member in Availity Essentials
- Enhanced and Standard CopayGo tiers and costs will return on 271 or in Availity
Check the individual provider's designated tier (Enhanced or Standard) in the list above
Apply the correct copay

In Highmark's Payer Spaces in Availity:

Hover over “Patient Registration” and click “Eligibility and Benefits Inquiry” (E&B).
Look for “CopayGo” plan in the Member E&B detail. The member E&B search can be initiated using any one of the following search options:
- Member ID/Policy Number + Date of Birth
- Member Last Name + First Name + Date of Birth
- Member ID/Policy Number + Member First Name + Last Name

A 270 electronic inquiry, will return a 271 response with corresponding copays for your provider group, but that transaction alone won’t tell you which providers in your office are Enhanced or Standard. If you don't know whether the provider is designated "Enhanced" or "Standard," you can check provider designation (Enhanced or Standard) in the list above.

Provider offices should take the copay that corresponds with the individual provider.

CopayGo member ID cards will also list Enhanced and Standard copay amounts (PCP, Specialist, and ER.) Members can show office staff real-time information in their MyHighmark app as proof of eligibility and provider Enhanced or Standard designation, as well as what copay should be taken. Copays will vary based on the members’ actual benefits.

Who is designated “Enhanced” and “Standard”?

CopayGo features a national provider network that will tier 20 individual primary care and specialty types of providers at the practitioner level:

Cardiothoracic Surgery	Cardiovascular Disease	Endocrinology
Gastroenterology	Nephrology	Neurology
Obstetrics & Gynecology	Oncology	Ophthalmology
Orthopedics	Otolaryngology	Pediatrics
Primary Care	Pulmonology	Radiation Oncology
Rheumatology	Surgery	Urology
Vascular Surgery

How do patients navigate CopayGo?

Members can search for Enhanced and Standard providers and associated copays in their MyHighmark member portal before they visit your office. CopayGo requires greater member engagement with the digital tools in their MyHighmark portal app to identify providers and associated copays. CopayGo enables members to more actively weigh the value of care options and puts the onus on members to “know before they go.” The digital aspect of the plan supports value transparency and allows members to work with provider offices to ensure the correct copay is taken.