Have you ever been confused by what your health insurance copayment responsibilities are when you go to your doctor’s office or pick up a prescription? It’s common to talk about your plan’s premium and deductible, but what about its copay? Have you ever wondered about a copay’s purpose? You’re not alone!

What is Copay?

Copay–short for copayment– is a set fee your insurance may require upon asking for different health services. Your insurance plan will inform you beforehand how much your copayment is for each doctor’s appointment, which often varies depending on what type of service you are requesting. Some healthcare providers–such as specialists–often require a higher copay than that of your primary doctor.

It’s important to pay close attention to your plan’s copay policy. For example, if it says you pay a $30 copay for a doctor’s visit, and $10 for a prescription, you are expected to pay that every time. Because copays vary with each plan, these fees may surprise you if you only paid attention to what your premium and deductible would be.

Make sure you factor in the copay cost when you are budgeting for your insurance plan. It’s possible that you choose an insurance plan with a lower premium, but it’s likely lower-premium plans will require a higher copay any time you visit a doctor. Be sure to bring into consideration how often you go to a health care provider when you compare those prices.

Factors to Consider

Knowing what an insurance plan requires of you in regards to copays may help you look more closely at the numbers which make up a health insurance plan you are considering. As you crunch your budget’s numbers and consider your finances, be sure to consider the following:

One: A copay is not the same as your out-of-pocket fees. It is almost always a separate fee, and many plans require you to pay the copay even after your deductible is met.

Two: Many insurance plans allow for an annual doctor’s visit for preventive care that comes built into the cost of the plan itself, and in that regard, the copay is waived. If your insurance plan offers such a service, but you have been avoiding going to the doctor because you dislike the thought of the additional copay fee, make sure you still take advantage of the services your plan provides!

Need Help?

If you live in or near Kosciusko County and need assistance reviewing your plan’s copay expectations, set up a time to meet with insurance agent, Michael Suhany today.