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 ?
While studies outside of correctional settings have demonstrated that co-payments negatively affect the demand for medical and dental services (Solanki, Schauffler and Miller, 2000; Harris and Custer, 1991; Kupor, Liu and Yoshikawa, 1995), only one study was found by Clark (1997), which anecdotally describes the impact of implementing a co-payment initiative on medical use in a county jail.
Employees usually care a great deal about their health plan options, especially when they share the cost of premiums and have to make significant co-payments. All employees--including those CPAs recommending which plans to offer--want to be able to count on their plan being there when they need it.
The higher a family's co-payment rate, the less often members of that family went to a doctor and the less often they incurred medical expenses generally.
For 240,000 British Columbian families, the new year brings the help they need with prescription drugs, thanks to a three-year $105-million investment that is reducing or eliminating deductibles and co-payments for lower-income households.
Co-payment is the practice where service providers, under the Health Insurance Scheme, take payment from patients while at the same time the NHIA reimburse the providers.
In the current practice, co-payment by the patient is to be paid according to the cost of the full packet and the cost can obviously be reduced if pharmacies supply the quantity as advised by the doctor.
Summary: The recent introduction of a Thiqa co-payment in Abu Dhabi has resulted in a significant reduction in Thiqa patient volumes since 1 July 2016.
The agencies warn, however, that, in that kind of situation, the coinsurance and co-payment requirements for the out-of-network ER care must be the same as the coinsurance and co-payment requirements for in-network ER care.
The researchers say the loss of income is likely to prompt many GPs to start charging a co-payment. Currently GPs are only able to charge the government directly for patient care (bulk-billing) if they do not charge the patient a co-payment.
Both the BMI and government payment systems employ co-payment rates that vary between plans and jurisdictions.
The funds will be taken from the proposed $7 GP co-payment.
1996) used administrative data to examine effects of changing co-payment levels on use of outpatient mental health services and found that in cross-sectional analyses, visit co-payments of $20 and $30 (compared to no co-payment) were associated with 30 and 50 percent reductions in service use, respectively.