What is a copay in health insurance?

• A. A copay is a fixed amount paid for a covered service at the time of service.
• B. A copay is a percentage of the total bill after deductible.
• C. A copay is a monthly premium.
• D. A copay is the annual deductible amount.

Answer: (A)

Copay is a fixed amount you pay for a covered service at the time you receive care. For example, you might pay a $20 copay for a doctor visit, and the insurer covers the rest of the allowed charge. This differs from coinsurance, which is a percentage of the cost after any deductible is met, and from a premium, which is the regular monthly payment to maintain the policy. It’s also not the deductible, which is the amount you must pay before most benefits kick in. So the fixed-at-service payment definition is what defines a copay.