Copayment

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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.

References in periodicals archive ?
He added that PSM had written to Finance Minister Lim Guan Eng in November 2018 and in January 2019 to conduct proper actuarial studies and consider other alternatives such as using Great Eastern's payment of RM2 billion to defray the co-payments required of patients going to government hospitals.
These are the first ever changes to Fair PharmaCare deductibles and co-payments since the program was created 15 years ago a long overdue step forward in improving the health and lives of thousands of British Columbians.
This is where co-payments on health insurance seems to be having a clear effect.
Drug manufacturers are prohibited from directly covering patients' prescription co-payments for Medicare or Medicaid, but they are allowed to donate to patient charities as long as they are independent of the pharmaceutical companies.
The agencies warn, however, that, in that kind of situation, the coinsurance and co-payment requirements for the out-of-network ER care must be the same as the coinsurance and co-payment requirements for in-network ER care.
The researchers say the loss of income is likely to prompt many GPs to start charging a co-payment. Currently GPs are only able to charge the government directly for patient care (bulk-billing) if they do not charge the patient a co-payment.
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.
They represent the total income of |the health funds and commercial insurance companies from the sale of supplementary insurance and the co-payments (in the health funds) for medicines and treatment.
1996) used administrative data to examine effects of changing co-payment levels on use of outpatient mental health services and found that in cross-sectional analyses, visit co-payments of $20 and $30 (compared to no co-payment) were associated with 30 and 50 percent reductions in service use, respectively.
On July 6, 2010, VA's Office of General Counsel determined this new law also exempts CD veterans from prescription co-payments. The law's effect on extended-care co-payment is still under review by VA's general counsel as of this writing, so these payments are currently not exempt and are not being canceled.
The new plan, apart from the low monthly premiums, includes: low co-payments when plan members use preferred pharmacies like Wal-Mart, Neighbourhood Market or Sam's Club pharmacies; In-store co-payments (at preferred pharmacies) on generic prescriptions as low as USD2.00 when plan members use preferred pharmacies; and co-payments as low as USD0.00 for generic prescriptions filled via Humana's RightSource home-delivery prescription service.
The definition of out-of-pocket costs varies and may include any one or a combination of expenditures paid by families for insurance premiums, deductibles, co-payments for health services, or items not covered by insurance such as home health personnel needed to assist with patient care and home care supplies, transportation, and costs to obtain services (Hwang, Weller, Ireys, & Anderson, 2001; Naessens et al., 2008).