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 ?
The researchers say the loss of income is likely to prompt many GPs to start charging 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.
The industry's subsidies have been condemned by health plans and pharmacy benefit managers, which contend that the aid undermines the use of co-payments to steer patients toward lower-price generic drugs.
On July 6, 2010, VA's Office of General Counsel determined this new law also exempts CD veterans from prescription co-payments.
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.
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.
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.
Therefore, increasing such co-payments among the elderly may be an ill-advised cost-containment strategy," he said in an interview.
BEIRUT: The American University of Beirut and the National Social Security Fund (NSSF) have signed an agreement whereby the latter will reimburse the university for outstanding out-patient co-payments that have been due since July 2002, a university statement said on Monday.
It is feared that co-payments could be the first stage of a "slippery slope" where a patient's ability to pay defines what treatment they receive - some doctors have argued that this is the first nail in the lid of the NHS' coffin.
Under the new Medicare Part D program, however, dual-eligible residents in assisted living communities are not exempt from prescription drug co-payments.
While the assessment by service providers and the Ohio Department of Rehabilitation and Correction (DRC) director is that co-payments are useful and are assisting inmates in taking responsibility, it is necessary to hear from those who are directly affected by the implementation of the policy.