Glossary Term

Copayment

A copayment is a specific dollar amount (e.g. $25) charged as an out-of-pocket cost for a medical service covered under a health plan. While copayments come in all amounts, medical services of differing costs may still have the same copayment obligation for the patient within a given health plan. The fixed fee aspect of a copayment is contrasted to a coinsurance fee, where a patient may not know his or her out-of-pocket obligations because the coinsurance fee is a percentage based on the entire cost of a medical service. Copayments likely influence whether to get a service or product as people will be deterred if they believe a service product provides them with little value, but will likely not induce shopping across providers since the person would likely bear the same cost.


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