Health insurance basics
What is a Copay?
A copay is a set dollar amount that you pay when you use a specific medical service or pick up a prescription.
The exact amount for each service is listed in the plan. Every plan is different.
A copay is a fixed amount
If your plan says a doctor visit has a $50 copay, you pay $50 for that visit. If urgent care has a $50 copay, you pay $50. A prescription might have a $15 copay.
Unlike a percentage, the copay is a set number listed in the plan.
Different services can have different copays
A primary-care visit, specialist visit, urgent-care visit, emergency-room visit, and prescription may each have a different copay.
Some plans let you use certain services for a copay before you meet the deductible. Other plans apply the deductible first. Every Plan is different.
The Ninja takeaway
A copay is the set amount you pay when you use a service. Look at the services and prescriptions you actually use—not just one copay printed on the plan.
This is why HealthPlanNinja customizes a plan specifically for your needs. Our licensed advocates are always free.