Copayment
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A copayment, or copay, is a predetermined fee for physician care, prescriptions, or services to be paid by the insured at the time of service. Copayments may vary for different services within the same plan.[1]
Overview
Copayments are fixed amounts paid for a covered medical service once the insured has met their deductible. Copayments typically are only a fraction of the cost of the service, with the rest of the cost paid by the insurance company. For example, an health plan may have a negotiated rate of $100 for a doctor's visit a required copayment of $20. The patient would be responsible for paying $20 at the time of service. However, if the insured has not met their deductible yet for the year, they may be responsible for the full $100.[2]
Copayment differs from coinsurance. In coinsurance, the insured is responsible for a percentage of the cost of service, rather than a fixed amount.[2]
See also
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