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What is a Copay?


What is a Deductible?

What is a Network Discount?

What is Coinsurance?

What is an Out-of-Pocket Maximum?

What is a Copay?

How Do I Lower My Premium?

Other Frequently Asked Questions


A copay is a benefit in an insurance plan that enriches the plan benefits and eliminates the need to satisfy a deductible in certain health related instances.

Let us be very clear, a Copay is not Coinsurance.

For example, say that you have a plan that has a $1500 deductible. Normally if you go to see a Doctor you would be required to pay for the office visit out of pocket until you have met your deductible. At that time a certain coinsurance contribution from the insurance company would be added to any office visits or other care that you need, going forward. This is entirely different than how a copay functions. In that same example, if your plan has a copay feature to it, you would not have to meet the $1500 deductible to receive the benefit of a copay for doctors office visits. If your plan as a 25$ copay for doctors office visits, then the deductible does not come into play, and you will only be charged $25 for an exam at your doctors office, regardless of if you have met the deductible or not.

(Note: if you are not familiar with what a deductible is, and what coinsurance is, we recommend that you visit these pages.
"What is a Deductible?", first, then "What is Coinsurance?"),

The best, but also most expensive, plans in the industry have several copay features encompassed into the plan. These copay features can eliminate the need to meet your deductible on most of your routine healthcare needs. They can even be as comprehensive as including higher level brand name drugs, and even emergency room illness visits, leaving you to only satisfy your deductible for major medical testing, such as EKG's, MRI's, CT Scans, and catastrophic events. Copay's are a great way to enrich the benefits of your medical coverage so that you do not end up using your hard earned dollars for high bills on routine medical care.

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