(redirected from Co-payment)
Also found in: Dictionary, Medical.


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 ?
This would allow GPs to bulk-bill the scheduled fee and also charge a co-payment.
The alternative benchmark plan carries higher co-payments and deductibles for employees to pay, but has no premium increase, he said.
To address the situation, which could cause sick people to worsen their condition due to lack of check-ups or follow-ups, the GPs have been sending text messages, assuring them the $7 co-payment isn't being collected yet.
The cards can cover much or all of a brand name drug's co-payment, putting the cost on par with a generic equivalent.
The co-payment level for a primary care ofice visit could range $25 at a platinum plan to $60 per visit for three visits per year at a bronze plan.
VA is changing its computer software systems to prevent co-payment charges from being billed to CD veterans.
The effect of co-payment increases also was magnified among Medicare managed care enrollees diagnosed with hypertension or diabetes and those who had histories of acute myocardial infarction, the study said.
And anyway, we already have co-payment within the NHS.
Another study examined more than 100,000 Kaiser Permanente HMO members, some of whom had a $25 to $30 co-payment for emergency visits.
Using the Medicare Drug Plan Finder, explore plans that cover your drugs and charge a higher monthly premium and standard co-payment.
But employees accustomed to thinking a doctor's visit costs a $15 co-payment are in for sticker shock once they start writing checks for deductibles.
The authors model such a co-payment scheme for one of the largest classes of prescription drugs: cholesterol-lowering (CL) therapy.