Copay
(copayment)
A set dollar amount you pay for a procedure or office visit. (Look at your plan summary very carefully) A copay is helpful because you’ll GENERALLY pay just the copay (unless other procedures are billed by your doctor in addition to the copay). For example, let’s say you see your family doctor for a sore throat. If your plan had a copay of $35 dollars, you’d pay the $35.
But wait, there’s more: Sometimes you can be billed more than just a copay. For example, let’s say you went to a specialist (specialist copays are generally more than a primary care doctor) to have a spot on your skin looked at. The office copay may be $50. You’d pay the $50 for the office visit. But if the doctor wanted to remove the spot, he could charge you/your insurance company for a “procedure”. That charge would be in addition to the copay. So the procedure could be billed to your insurance company and you’d pay whatever your insurance company had negotiated with the doctor for that procedure.
