Co-pay

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Co-pay

Co-pay (pronounced: /koʊˈpeɪ/), also known as co-payment, is a fixed amount a healthcare consumer pays for covered health care services after their health insurance plan begins to pay.

Etymology

The term "co-pay" is derived from the concept of "co-payment", where "co-" means "together" or "jointly", and "payment" refers to the act of giving money in exchange for goods or services. Thus, it signifies a payment made jointly by the insurance company and the insured individual.

Definition

A co-pay is a predetermined rate you pay for healthcare services at the time of care. For example, you may have a $30 co-pay for a doctor's visit or a $15 co-pay for a prescription. Co-pays are a specified dollar amount rather than a percentage of the bill, and they're part of your out-of-pocket costs.

Related Terms

  • Deductible: The amount you pay for covered health care services before your insurance plan starts to pay.
  • Premium: The amount you pay for your health insurance every month.
  • Coinsurance: Your share of the costs of a covered healthcare service, calculated as a percent (for example, 20%) of the allowed amount for the service.
  • Out-of-pocket maximum: The most you have to pay for covered services in a plan year. After you spend this amount on deductibles, co-payments, and coinsurance, your health plan pays 100% of the costs of covered benefits.

See Also

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