A health insurance copay (or copayment) is a fixed, predetermined fee that a patient pays out of pocket at the time of receiving a healthcare service. This fee is part of the cost-sharing arrangement between the insured person and the insurance provider. Copays typically apply to services such as doctor visits, prescriptions, lab tests, or emergency room visits, and the amount can vary depending on the type of service or whether the provider is in-network or out- of-network.
Copays are different from deductibles, which are the amount paid out-of-pocket before insurance begins to cover medical costs. A copay is usually a flat fee you pay for each service after meeting any deductible requirements. For example, you might pay $20 for a primary care visit and a higher copay for a specialist or an imaging test.
In summary, a copay is an upfront, fixed payment you make for certain medical services as part of your health insurance policy.
