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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 ?
Treasurer Melinda Ernst-Fournier said there had been confusion among employees on the benchmark plan, which offers co-payments and deductibles that mirror the most heavily enrolled GIC plan.
The Co-Chairs of the Close the Gap campaign have called on the Australian Government to consult with Aboriginal and Torres Strait Islander healthcare providers to ensure changes to the GP co-payment are in the best interests of Aboriginal and Torres Strait Islander people.
But we would be very concerned if employers raised co-payments for nurses as a result of the study, as this would reduce access and affordability for clients," she said.
Co-payments will also demonstrate healthy growth of 9.
The researchers say the loss of income is likely to prompt many GPs to start charging a co-payment.
The staff at three Ohio women's institutions believe that the rates of requests for medical services have not seen a dramatic decrease since the implementation of co-payments.
But employees accustomed to thinking a doctor's visit costs a $15 co-payment are in for sticker shock once they start writing checks for deductibles.
Veterans who have no injury or illness related to their prior military service-referred to as Priority Groups 7 and 8-will also see their co-payments increase, but there is no cap on annual payments for outpatient medicine.
A control group whose co-payments didn't change switched to a cheaper drug in 2 percent to 17 percent of cases and stopped taking them in 6 percent to 19 percent of cases.
A co-payment of $2 or $3 looks like small change to most people, including those covered by private insurance plans, which often require much larger co-payments for prescription drugs.
Small co-payments are attached to some of these reimbursements.
One new provision is the elimination of co-payments for active-duty family members (ADFM) enrolled in TRICARE Prime.