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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 ?
This would allow GPs to bulk-bill the scheduled fee and also charge a co-payment.
Premiums are the largest category of spending but co-payments and direct payments are growing," said Bruce Carlson, Publisher of Kalorama Information.
The alternative benchmark plan carries higher co-payments and deductibles for employees to pay, but has no premium increase, he said.
However, in the absence of an exemption for Aboriginal and Torres Strait Islander people especially clients of ACCHS the proposed co-payment for visits to the doctor and the proposed increase in co-payments to the Pharmaceutical Benefits Scheme (PBS) continued to cause great anxiety, the Co-Chairs said.
To address the situation, which could cause sick people to worsen their condition due to lack of check-ups or follow-ups, the GPs have been sending text messages, assuring them the $7 co-payment isn't being collected yet.
And anyway, we already have co-payment within the NHS.
Another study examined more than 100,000 Kaiser Permanente HMO members, some of whom had a $25 to $30 co-payment for emergency visits.
Using the Medicare Drug Plan Finder, explore plans that cover your drugs and charge a higher monthly premium and standard co-payment.
Adding up payroll deductions for premiums of both plans, plus co-payments, deductibles and tax advantages, he computed saving about $700 annually.
One company switched from a flat co-payment system to a three-tier system, the other from a two-tier to a three-tier system.
Starting July 1, the health plan will require a co-payment for psychiatric drugs - $2 for generic drugs, and $3 for brand-name drugs.
And although consumers with prescription plans pay little or nothing for Claritin, Allegra, and Zyrtec at the point of sale, the cost shows up in higher insurance and co-payment rates.