What is a copayment?

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Multiple Choice

What is a copayment?

A copayment is the fixed amount a patient pays at the time of service. This dollar amount is set by the insurance plan and is paid upfront, regardless of the total charge for the visit. It differs from coinsurance, which is a percentage of the allowed amount paid after any deductible is met, and from a preauthorization requirement, which is a procedural approval, not a payment. It also isn’t the insurer’s fixed amount charged or a percentage of the deductible. In practice, you might see a plan require a $20 copayment for a primary care visit, paid right at the point of service.

A copayment is the fixed amount a patient pays at the time of service. This dollar amount is set by the insurance plan and is paid upfront, regardless of the total charge for the visit. It differs from coinsurance, which is a percentage of the allowed amount paid after any deductible is met, and from a preauthorization requirement, which is a procedural approval, not a payment. It also isn’t the insurer’s fixed amount charged or a percentage of the deductible. In practice, you might see a plan require a $20 copayment for a primary care visit, paid right at the point of service.

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