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Copayment
(redirected from copay)

   Also found in: Dictionary/thesaurus, Medical, Wikipedia 0.02 sec.

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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This is necessary because an individual is defined by the new Medicare law as "institutionalized" for the purposes of determining copay amounts if he or she is expected to reside in an institution for more than 30 days.
It's a convenient tool for many people and we're happy to provide it as one of our offerings, but the reality is that we've had to make sure copay amounts for mail service actually don't end up costing us money," said Robert Wanovich, director of clinical pharmacy services.
Our group plans include five copay plans, plus our newest plan, Protect HSA, the only high deductible healthcare plan designed exclusively for CalCPA members.
 
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