#INSURANCE: What is a co-payment?

health insurance:  What is a co-payment?

A co-payment, or co-pay, is a fixed amount that you pay for a
covered health care service, usually when you get the service.
The amount can vary by the type of service.
Total cost of office visit
Office visit
Co-pay
Hospital
Co-pay
Medicine
Co-pay
Amount
paid by
insurance
Amount
you pay
Did you know?
Have you heard of shared decision making? Shared
decision making is a process by which patients and their
health care providers make health care decisions together,
taking into account the best medical information available,
as well as the patient’s values and choices. When you and
your health care provider discuss treatment options, make
sure to consider what your
insurance will cover

What is a deductible?
A deductible is the amount you owe for covered health care
services before your health insurance plan begins to pay.
For example, if your deductible is $1,000, your plan won’t
pay anything (except for preventive services and other
excluded services in the SBC) until you’ve paid $1,000 for
covered services. (Insurance pays for covered services above
the deductible, but you may be responsible for a co-pay or
coinsurance.)

Insurance pays for
covered services above
the deductible
Deductible
Amount you pay
before insurance
begins to pay

Medical expenses
It’s important to find out what is and what is not included in

What does maximum out-of-pocket mean?
Maximum out-of-pocket is the most you’ll have to pay for
covered services in a benefit year. After you reach this amount,
your health plan will pay for all covered essential health benefits
from an in-network provider.

Insurance pays for all
covered services above
your maximum amount
Maximum
out-of-pocket
The maximum amount
you will have to pay in
the benefit year
your plan’s deductible. Check to see
Medical expenses