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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 ?
In addition to $0 co-pays for primary care physician visits, WellCare Medicaid members in South Carolina now have $0 co-pays for treatment at ambulatory surgery centers, Federally Qualified Health Centers and rural health clinics; with chiropractors, optometrists and podiatrists; and for home health and durable medical equipment.
The co-pays for primary care provider visits will vary based on the member s plan.
Co-pays that inhibit preventive consultations diminish the chance of a healthy life.
Thanks to the new health care law, women are guaranteed coverage without co-pays for annual well-women visits, contraception, contraceptive counseling, breastfeeding counseling and equipment, and HIV counseling and testing.
According to the committee, charging patients a 20% co-pay for lab work would save Medicare $23 billion over ten years.
Maternity care is fully covered, and there are low co-pays for adult personal care physician visits, low or no co-pays for sick-child doctor visits and reimbursement of up to $300 for fees associated with any youth sport such a soccer, lacrosse, baseball or hockey.
For most employees, any additional out-of-pocket costs for co-pays will be offset by the 4 percent lower payroll deduction for insurance.
School districts should adjust deductibles and co-pays on a regular basis to account for health care inflation.
After a week of uncertainty, she was told Wednesday afternoon that a doctor's note sent to the insurer will enable her to get the drugs with a $3 co-pay each.
Veterans with annual incomes that do not exceed the amount of VA pensions are not affected by the co-pay increase.
We should also pay more attention to the absurd results of co-pays and other "moral hazard" charges--intended less to raise revenue than to reduce the use of medical care, supposedly to prevent abuse and therefore save money.