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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 ?
The Octapharma Co-Pay Assistance Program is available to primary humoral immunodeficiency patients who are currently receiving Octagam Immune Globulin Intravenous (Human) 5% Liquid Preparation or have a prescription to begin therapy; and those age 18 or older with chronic immune thrombocytopenic purpura who are currently receiving Octagam Immune Globulin Intravenous (Human) 10% Liquid Preparation or have a prescription to begin therapy.
People enrolled in the AARP MedicareComplete Plan 1 (HMO) and AARP MedicareComplete Essential (HMO) plans will pay a $0 co-pay for visits with tier 1 primary care providers, as compared to $10 for tier 2 primary care providers.
That might involve getting a manufacturer's so-called co-pay card for a patient, helping an eligible Medicare patient receive free medication from a drug maker or expediting the delivery of medication.
The majority of co-pay card programs fall short of the expected return on investment (ROI), because they are not tracked or monitored to the degree and frequency that they could be, they said.
Only 62 percent of the workers in plans that cover more than 1,000 employees have to pay a co-pay for an in-network office visit, but 35 percent have to pay a coinsurance amount.
Because most plans' coverage periods start at the beginning of the calendar year, many women gained access to these important services without co-pays in January.
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 ambulance service can bill her for the co-pay, which it admits to not having tried.
Many pharmacies are required under contract with pharmacy benefits managers to run prescriptions through consumers' insurance regardless of whether or not the co-pay is higher than the retail price.
In a July 31 letter to the committee's Democrat and Republican leadership signed by 26 lab organizations and industry members, including AMT, the coalition registered its "strongest opposition to the implementation of a Medicare clinical laboratory co-pay," and warned that the lab community would oppose any healthcare reform bill that included such a provision.
Here, affordable premium and future co-pay are of paramount importance.