What is a “co-payment” in health insurance?

A co-payment, commonly referred to as a "co-pay," is a fixed amount that the insured is responsible for paying at the time of receiving specific health care services. This amount is predetermined by the insurance policy and can vary depending on the type of service provided. For example, an insured might pay a different co-payment for a primary care visit compared to a specialist consultation or for prescription medications.

This arrangement helps to share the cost of healthcare services between the insured and the insurance provider, making it more affordable for consumers at the point of service. Co-payments do not count towards the deductible and typically apply after the deductible is met, depending on the policy.

Other options do not accurately reflect the definition of a co-payment. The total amount paid for an insurance policy annually refers to premium costs, while the total cost of all premiums over a lifetime illustrates a different aspect of insurance contracts. An additional fee for out-of-network services typically describes out-of-pocket expenses that might occur when an insured chooses a provider not contracted with their insurance plan, rather than a co-payment for standard services.