{"id":352623,"date":"2017-07-18T17:28:11","date_gmt":"2017-07-18T22:28:11","guid":{"rendered":"https:\/\/content.findlaw-admin.com\/ability-law\/consumer\/insurance\/what-is-an-insurance-copay.html"},"modified":"2024-03-28T15:28:24","modified_gmt":"2024-03-28T20:28:24","slug":"what-is-an-insurance-copay","status":"publish","type":"page","link":"https:\/\/www.findlaw.com\/consumer\/insurance\/what-is-an-insurance-copay.html","title":{"rendered":"What Is an Insurance Copay?"},"content":{"rendered":"\n
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What Is an Insurance Copay?<\/h1>\n
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\n By Oni Harton, J.D.<\/a> | Legally reviewed by Melissa Bender, Esq.<\/a>\n | Last updated\n
\n \n <\/i>\n Legally Reviewed\n <\/summary>\n\n
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This article has been written and reviewed for legal accuracy, clarity, and style by FindLaw\u2019s team of legal writers and attorneys<\/a> and in accordance with our editorial standards<\/a>.<\/em><\/p>\n\n <\/div>\n <\/details>\n\n

\n \n <\/i>\n Fact-Checked\n <\/summary>\n\n
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The last updated date refers to the last time this article was reviewed by FindLaw or one of our contributing authors<\/a>. We make every effort to keep our articles updated. For information regarding a specific legal issue affecting you, please contact an attorney in your area<\/a>.<\/em><\/p>\n\n <\/div>\n <\/details>\n<\/section>\n

Health care and insurance costs are rising for both policyholders and insurance companies. Every dollar counts. Many people rely on health insurance<\/a> to help pay for routine, preventative, and emergency medical treatment. Millions of Americans also depend on insurance to help pay for prescription medications.<\/p>\r\n

One way insurers can control costs is through the use of copays. Insurers use copays to prevent abuse of insurance policy benefits. Copays help address unnecessary or overly expensive insurance claims. They can also help bring down premium costs.<\/p>\r\n

Policyholders pay a portion of the health care costs. A copayment represents your responsibility for your medical care costs.<\/p>\r\n

Read on to learn more about the role of a health insurance copay and how it works with other health care costs.<\/p>\r\n

Copays Defined<\/h2>\r\n

A health insurance copay or copay amount is a fixed amount that insureds pay out-of-pocket for covered medical expenses. Some health insurance plans require insureds to pay an out-of-pocket cost. Copays are a specific dollar amount, not a percentage of the total cost of the medical bill.<\/p>\r\n

When Do You Have a Copay?<\/h2>\r\n

Some insurance policies pay 100% of the cost of certain types of care, like annual check-ups and preventative care. For such visits, you wouldn’t have to make any copayment.<\/p>\r\n

However, policyholders can be required to pay this out-of-pocket expense. Your plan may outline copay amounts for different health care services, such as:<\/p>\r\n