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 ?
Ilem also noted that the copayment proposals contradict the VA's current copayment policy for care provided in VA facilities and runs counter to outlines within the MISSION Act requiring that veterans not pay more for community care than they would for comparable services at the VA.
of being required to pay a copayment g([v.sub.ij]) = [[beta].sub.0] + [[beta].sub.1] on overall [YR2001.sub.j] + [[beta].sub.2] [YR2002.sub.j] + [[beta].sub.3] [YR2003.sub.j] mean VA specialty + [[beta].sub.4][MUSTPAY.sub.i] + care expenditures [[beta].sub.5][MUSTPAY.sub.i] x [YR2001.sub.j] in each year?
"Our research demonstrates that not only does eliminating medication copayments following a heart attack positively impact the disparity we know exists in cardiovascular care and improve outcomes for nonwhite patients, it also has the potential to dramatically reduce healthcare spending for this high-risk group."
The authors illustrate the importance of considering behavioral hazard in the context of a recent large-scale field experiment that eliminated copayments for one group of recent heart attack victims, while another group faced a 25 percent copayment.
In some states, kids like Lissa might qualify for a Medicaid waiver, which would cover the copayment; those families would need to be connected to resources that could assist them in the application.
In contrast to current Medicare policy the Medicare Payment Advisory Commission has issued a new recommendation that seniors be charged copayments for home health care visits.
Tiered copayments for prescription drugs have long been a part of insurers' cost containment strategies, with patients paying fixed amounts from their own funds when a prescription is filled; the dollar amounts vary depending on the cost of a particular drug and whether a less expensive--generic--alternative exists.
Recorded retail transactional data included coverage and copayments.
Review your health care policy to see whether your deductibles, copayments, and co-insurance count towards this limit."
Small insurance copayments are enough of a deterrent to keep many older women from getting mammograms to detect breast cancer, according to a recent study.
Trivedi noted that older patients often have increased health care expenses, which can make even a small copayment a substantial financial deterrent.
In 2006, Senators Gordon Smith, Hillary Clinton, and Bill Nelson introduced the Home and Community Services Copayment Equity Act of 2006, but unfortunately it was not passed.