By InsuranceMatchup Staff Writer
With most common health insurance coverage comes something called the copay, which the insured party is responsible for. Most commonly, this will be charged when visiting a doctor's office. But why is there a health insurance copay on doctor's office visits?
To answer this question, you first have to understand what a copay is. Basically, a copay is just a flat fee paid to the doctor's office each time the insurance is used. It usually runs between $10 and $40 and is charged up front prior to a doctor's office visit. The amount will also vary depending on the type of doctor you are visiting. Specialists sometimes require a higher amount of copay.
That's really all there is to the copay itself. Now as for why a copay is charged, that's a little more complicated. Not all insurance plans will require a copay for doctor's office visits. But, the plans with a copay will pay 100 percent of the charges incurred following the set amount of the copay.
So, let's say you go for a normal doctor's office visit. If you have a $20 copay, you'll be charged $20 before you leave the office. That's not the total cost of the visit. The whole process may cost upwards of $500, depending on what you had done. What this means is that you are only responsible for your $20, and the insurance takes care of the other $480, or 100 percent of the cost after the copay was deducted.
Copay insurance is very common, especially for office health insurance plans. In some cases, copays may not make a lot of sense, as they won't count towards any out-of-pocket maximum costs that the insured person has to pay each year. But it will help with the most common uses of health insurance, the doctor's visit.