Copayment

Copayments, often called copays, are a common feature of health insurance plans, especially in the United States. Instead of paying the full cost of a doctor's visit or prescription, the insured person pays a set fee at the time of service.

For example, a health plan might require a copayment of 25 for a visit to a family doctor, 50 for a specialist and 10 for a generic prescription. If a specialist visit costs 200, the patient pays 50 and the insurer pays the remaining 150.

Copayments help share costs between insurers and patients and discourage unnecessary use of medical services. Depending on the plan, copayments may apply before or after the deductible has been met, and they usually count towards the plan's out-of-pocket maximum.

Copayments differ from coinsurance, where the patient pays a percentage of the cost rather than a fixed amount. Many plans use both, with copayments for routine services such as doctor visits and coinsurance for larger costs such as hospital stays. In countries with publicly funded healthcare, similar fixed charges exist for some services, such as prescription charges.