Sometimes it feels like you have to learn a second language just to sign up for health insurance, especially if you’re exploring your options for the first time. If you’re hoping to navigate insurance websites and health plan brochures without a dictionary on hand, figuring out copays is a good place to start.
What Is a Copay, Exactly?
Short for “copayment,” a copay is a fixed amount of money paid by the insured customer — that’s you — every time they use a certain service. So, for example, when you go to the doctor’s office, it’s likely you’ll have to shell out a small amount of money. The same goes for picking up a prescription or going to a physical therapy session.
Copays usually come into play once you’ve spent enough to reach your plan’s deductible. At that point, most insurers will charge you the copay while they cover the rest of the cost according to the plan.
What Is a Copay Going to Cost Me?
The copay is set by the insurance company and can change depending on what type of service you receive. You might pay one amount to see your primary care doctor and another to see a specialist, and brand name medications could have different copays from generic ones. With some types of insurance plans, you might pay a high copay if you go outside your provider network.
Luckily, you don’t have to wait until you whip out your wallet to find out what your copay is. What you’ll pay for any given service should be listed on your insurance ID card or in your insurance paperwork. When in doubt, contact your insurance provider — they’ll be able to provide detailed information on how much various services will cost you.
Depending on your medical needs, copays can be a recurring out-of-pocket cost. It’s good to get a sense of what you’ll pay for medical services early on — do your research and avoid sticker shock when you get to the doctor’s office or the pharmacy counter.