Copayment

What Does Copayment Mean?

A copayment, or co-pay, is a fixed amount that a health insurance policyholder is required to pay for covered medical services, such as eye or hearing exams.

Insuranceopedia Explains Copayment

Unlike coinsurance, which requires the policyholder to pay a percentage of covered healthcare costs, a copayment is always a fixed dollar amount based on the specific service. The schedule of benefits outlines the copay for each covered health service. For example, it may be $10 per prescription, $15 for routine doctor visits and exams, and $100 for an emergency room visit.

Copays are one of several out-of-pocket costs that sit alongside premiums, deductibles, and coinsurance, and a breakdown of how each piece works together makes plan comparisons easier when you’re shopping for coverage. When the copays on your prescriptions and visits start to add up over the year, there are a few practical ways to bring your overall health insurance costs down without dropping coverage you actually use.