Co-pay
Categories: Insurance
Co-pilot. Co-sine. Cos-play.
Oh, those annoying co-pays. You and/or the company you work for pay a lot each month for health insurance coverage, and then you get to the doctor’s office and they charge you a co-pay. Welcome to today’s world of skyrocketing medical costs.
A co-pay is a fixed amount, usually $20 or more, that you pay for a covered health service. It could be for a prescription, emergency room visit, surgery, or just a regular wellness visit. So whether or not you've met your deductible, you will still have to come up with the co-pay amount. (A deductible is the amount you pay before the insurance company starts paying your claims. If your plan has a $1,000 deductible, for example, you will have to pay the full amount of all your medical bills until you hit the $1,000 threshold.)
Jenny has a migraine and goes to see a specialist. Her deductible is $500 and the co-pay is $25. As soon as she checks in, she is asked for the co-pay. The cost of the visit is $200, so if Jenny has not yet met her deductible, she will have to pay that full amount as well.
The co-pay amount could be different for different services, such as lab tests, prescription drugs, or an appointment with a specialist. Also, the lower the co-pay, generally the higher the insurance premium, and vice versa. It definitely pays to read through the fine print if you have a choice of medical plans, in order to compare co-pay amounts as well as deductibles.
Many companies also offer Health Reimbursement Accounts (HRA) or Health Savings Accounts (HSA) to help cover out-of- pocket medical expenses. An HRA is employer-funded up to a certain amount, while an HSA is funded by the employee for an amount of their choice with pre-tax dollars. This way you can get reimbursed for those irritating co-pays.