Understanding Confusing Health Insurance Terms: Copays

Over the years, many Blue Ridge, GA residents have contacted us at The Insurance Mart about confusing insurance terms, such as copays. Thankfully, this concept isn’t as hard to understand as you may think, mainly when explained to you by a trusted professional who fully understands it.

What is a Copay?

A copay is a flat fee that you have to pay for certain types of health services. This fee may change depending on your service and your provider. For instance, you may have a $25 copay for all doctor visits and a $30 copay on your medications. This means you have to pay this money upfront, while your insurance company will pay the remaining portion of your bill.

Insurance companies set these up as a cost-sharing technique to help cut back significantly on your bills. For example, you may end up paying less than 10 percent of your doctor visit with a copay. These payments can be adjusted in some ways by increasing your monthly bills or changing your plans – doing so may decrease what you pay.

Is a copay the same thing as coinsurance? No, because a coinsurance cost is indicated by a percentage and not a flat rate. For example, a copay on your medicines would be listed as $25 – meaning you have to pay $25 whenever you get your prescription. But a coinsurance of 20 percent means you’d pay 20 percent of whatever you bill costs: with your insurance company taking up the 80 percent that you do not pay.

Contact Us to Learn More

If you still need help understanding the nature of copays in Blue Ridge, GA, and want to talk to someone you can trust, please reach out to us at The Insurance Mart right away to get the valuable insight you need. We can help you fully understand your copay and do what we can to decrease their costs.