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

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.

Dictionary of Financial Terms. Copyright © 2008 Lightbulb Press, Inc. All Rights Reserved.
References in periodicals archive ?
Copay assistance isn't limited just to "brand" drugs.
Today, nearly all health plans cover prescription contraceptives at varying copays. Monthly birth control copays typically range from $10 to $50; copays and other out-of-pocket expenses for long-term contraception cost significantly more up-front.
On Monday, it was announced that the Health Ministry's "Concept for better health care 2010 - 2015" is planning changes, which envision that patients should copay for treatment in hospitals.
Examples of Copay Reduction and Patient Rebate Programs Copay Reduction/ Medication Company Rebate * Eletone[R] Ferndale The Treatment (nonsteroidal Laboratories, Inc.
In other words, if the patient has only had 2 doctor visits in his or her insurance calendar year, the office is to collect a $30 copay for the day.
The study bolsters the idea of "value-based insurance" in which insurers lower copays and other costs to patients as a way to promote the use of tests and drugs that are proven to be cost effective in the long run.
"But if you're a mother with four kids, and you used to have a $15 copay for each visit to the pediatrician but now it costs you $120, will that push you into the emergency room?"
The Senate copay mandate, absent from the House's Medicare legislation, has been championed by Finance Committee chair Sen.
Saunders says a typical three-tier plan might charge a $5 employee copay for generics, a $15 copay for brand-name drugs on the formulary, and a $25 copay for non-formulary drugs.
Individual drug requirements along with enrollment and adjudication programs have strict guidelines that are unique to each pharmaceutical copay program and specific medication.
Eligible commercially insured patients will pay a USD0 copay if they are new to Toujeo for their first three prescription fills and a USD10 copay for their next 12 fills.