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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.


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.

References in periodicals archive ?
While education ranked low on the list, the two solutions ranked highest were rewards (40%) and co-pay discounts (39%).
4) add a monthly--not yearly--co-pay dollar-amount cap, at least for lower-income Extra Help Part D patients under 150% of poverty to prevent co-pays for those with many genuine prescription needs from eating up their low incomes.
Selectmen are considering a plan that increases the co-pay to between $10 and $20.
Veterans with less severe service connected disabilities-those classified as Priority Groups 2 through 6--will see their prescription drug co-pays rise by $1.
Co-pays / Orthodontia coverage Varied--dental plan co-pays and
Doubling the co-pay to $10 for any type of drug results in a 22 percent decrease in cost; the average annual drug cost per employee was $563.
Employers will shift an increasing share of rising medical and prescription drug costs to consumers through higher co-pays and defined contributions.
Petrocy volunteered even though the co-pay increase didn't affect her directly.
About the Patient Advocate Foundation (PAF) Co-Pay Relief Program (CPR)
Two years ago Bush raised the veterans co-pay from $2 to $7 (at the same time Congress received a substantial boost in salary).
Tensions Rising between Branded Drugmakers and Health Plans" analyzes the Co-Pay Coupon lawsuit and the implications for branded drugmakers and health plan providers.
There is a $10 co-pay for generics and a $25 co-pay for brand-name drugs.