What is a copay in a health insurance plan?

• A. A fixed amount you pay for a covered service, like a doctor visit or prescription, at the time you receive care
• B. The total annual deductible
• C. The monthly premium
• D. The out-of-pocket maximum

Answer: (A)

A copay is a fixed amount you pay for a covered service, such as a doctor visit or prescription, at the time you receive care. This per-service payment is the amount you owe regardless of the total cost of the visit. It’s different from the deductible, which is the amount you must pay out of pocket before the plan starts sharing costs; from the monthly premium, which you pay to keep your coverage active; and from the out-of-pocket maximum, which is the cap on how much you pay in a year for covered services.