Copay
A fixed dollar amount you pay for a specific healthcare service (e.g., $30 for an office visit).
A copayment is a fixed-dollar amount you pay at the time of service for a covered healthcare service. Common copay amounts: $20-50 for primary care, $30-75 for specialist, $100-300 for ER, $5-50 for prescriptions. Copays count toward your out-of-pocket maximum but typically not your deductible (depends on the plan). Some plans require deductible to be met before copays apply.
Frequently asked questions
What is copay?
A copayment is a fixed-dollar amount you pay at the time of service for a covered healthcare service. Common copay amounts: $20-50 for primary care, $30-75 for specialist, $100-300 for ER, $5-50 for prescriptions. Copays count toward your out-of-pocket maximum but typically not your deductible (depends on the plan). Some plans require deductible to be met before copays apply.
Related terms
- DeductibleThe amount you pay out of pocket each year before your insurance starts paying. Resets every plan ye
- CoinsuranceYour percentage share of a healthcare service cost after you've met your deductible — usually 10-30%
- Out-of-pocket maximum (OOP max)The most you'll pay out of pocket in a plan year before the insurer covers 100% of covered services.
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