What’s the deal with Copays?

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(Also called co-pays, copayments)

A copay is an amount you need to pay upfront, usually before you see a doctor, dentist, therapist or other healthcare provider. This copay does cover part of your expenses for the visit, but you won’t usually see it shown on your bill, subtracted from whatever total amount you might end up owing.

Many health insurance plans have different copays for different types of services. For example, you might have a $20 copay to see your doctor, but a $50 copay to go to a Specialist.

The idea behind copays is that some people would go to the doctor for every little thing if there wasn’t some part of the cost they shared upfront. (And then there’s those of us who won’t go to the doctor even if you GAVE us money upfront.)

Good things to know about Copays:

  • Your copay usually doesn’t count towards your deductible or out-of-pocket maximum.
  • Your copay usually only covers a portion of the cost of your healthcare service. You might still owe your doctor more money than just your copay.
  • Be sure not to confuse copays with coinsurance, even though they sound ridiculously similar.
Leave a comment

3 Comments

  1. anonymous

     /  July 6, 2012

    My friend recently hurt himself during the day and just said the he would wait to go to ER that night because he couldn’t get in to see his doctor. A lot of the time we don’t think about the fact that urgent care is available, typically, for the same co-pay as a doctor’s appointment. That sure beats waiting in pain just to go to ER that can have a co-pay as much as $100.00 or more!

    Reply
    • This is a great call. I routinely injure myself, and I’ve actually found that unless you’re really hurt or sick (we’re talking blood flowing hurt), you won’t get in right away and might actually wait longer at the ER. Urgent Care has a lower copay, and it’s usually pretty efficient.

      Reply
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