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Copayment
(redirected from Co-pay)

   Also found in: Dictionary/thesaurus, Medical, Wikipedia 0.01 sec.
Copayment
In insurance, a fee that a policyholder must pay for certain covered items for which the insurance company otherwise pays. For example, a check-up with a doctor may cost the policyholder a copayment of $25, with the insurance company paying for the remainder of the cost due. A copayment is also called a co-pay and should not be confused with a deductible. It exists to discourage policyholders from abusing the insurance policy.

Copayment. If you have a managed-care health insurance plan, your copayment is the fixed amount you pay -- often $10 to $25 -- for each in-network doctor's office visit or approved medical treatment

In some plans, the copayment to see a specialist to whom you're referred is higher than the copayment to visit your primary care physician. Some plans may not require copayments for annual physicals and certain diagnostic tests.

If you see an out-of-network provider, you are likely to be responsible for a percentage of the approved charge, called coinsurance, plus any amount above the approved charge.



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The $10 co-pay for a visit to a primary care physician and the graduated $10-$25 co-pays for prescription drugs are unchanged.
According to the VA, some veterans received phone calls from a man indicating he was from the "VA pharmacy" who asked veterans for their Social Security number and a list of medications because of "new co-pay regulations.
For those with an income below the poverty line (currently $798 per month for a single person, in September 2005), there will be no premiums or deductibles, but there will be a co-pay of $1 for generic meds and $3 for brand-name meds, with no co-pay after total drug expenses reach a certain limit.
 
 
 
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