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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.
Farlex Financial Dictionary. © 2012 Farlex, Inc. All Rights Reserved


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.

Dictionary of Financial Terms. Copyright © 2008 Lightbulb Press, Inc. All Rights Reserved.
References in periodicals archive ?
SilverScript Choice is a basic plan that offers comprehensive coverage with competitive premiums, $0 deductible on all covered drugs in 47 states, and $0 co-pays for 90-day supplies of Tier 1 drugs nationwide when filled through the CVS Caremark Mail Service Pharmacy.
Co-pays are required for doctor prescriptions and in- and out-patient visits.
Managed care services company WellCare Health Plans (NYSE:WCG) said on Friday that it is eliminating co-pays for primary care physician visits and other medical care services for its South Carolina Medicaid members effective 1 November 2015.
Co-pays that inhibit preventive consultations diminish the chance of a healthy life.
About 66 percent of private-sector employees must pay a co-pay for typical in-network office visits, and 27 percent must pay a coinsurance amount for an office visit.
Their advantage is that the monthly private insurance premium covers prescription drugs and more services than traditional Medicare (e.g., optometry, hearing tests, dental plan options), with low or no co-pays. They also have limits on out-of-pocket expenses.
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.
The same problem exists for emergency room co-pays. The average emergency room visit involves a co-pay of $76, which might not be high enough to dissuade plan participants from visiting emergency rooms for problems better solved elsewhere.
The RxCut[R] price on 21 of the 25 most frequently processed generic prescriptions, for their members, has been lower than an insurance co-pay of $10 or more.
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.