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What is the difference between deductible and copay?

Copays are a fixed fee you pay when you receive covered care like an office visit or pick up prescription drugs. A deductible is the amount of money you must pay out-of-pocket toward covered benefits before your health insurance company starts paying. In most cases your copay will not go toward your deductible.

How is copay determined?

Your copays are determined by your insurance plan Other plans charge what's known as coinsurance, which means you pay a percentage of the total medication cost, instead of a fixed amount. In this case, the pricier the med is, the higher your copay will be.

What does 80% copay mean?

What Is Coinsurance? Coinsurance is the percentage of covered medical expenses you pay after you've met your deductible. Your health insurance plan pays the rest. For example, if you have an "80/20" plan, it means your plan covers 80% and you pay 20%\u2014up until you reach your maximum out-of-pocket limit.

Why do you have to pay a copay?

Copays are a form of cost sharing. Insurance companies use them as a way for customers to split the cost of paying for health care. Copays for a particular insurance plan are set by the insurer. Regardless of what your doctor charges for a visit, your copay won't change.

Do I have to meet my deductible before copay?

A deductible is a set amount that you must meet for healthcare benefits before your health insurance company starts to pay for your care. Co-pays are typically charged after a deductible has already been met. In most cases, though, co-pays are applied immediately.

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