About Insurance Co-pays and Deductibles

You can find information about the specific amount of your co-pay on your insurance card. In addition to paying monthly premiums for health insurance, you also retain responsibility for paying co-pays and for the cost of health care services rendered within your deductible amount. Your introductory health insurance packet normally contains information about this amount.

Co-pay Facts

• When you visit a doctor, your health insurance provider may require you to make a co-payment, or co-pay, which normally ranges between $10 and $50, as of 2011, depending on your insurance plan. Your health insurance provider may require you to pay a higher co-pay amount if you see a specialist, visit an urgent care center or enter the emergency room. Most doctors and specialists require you to make your co-payment when you check in for your appointment. Standard co-pay amounts may also apply to generic prescriptions.

Deductible Facts

• Your health care deductible is the total amount of health care costs you are responsible for paying for in a calendar year. Once you exceed your annual health care deductible, your insurance pays in full for any services or procedures you require, excluding co-pays. Depending on your health insurance plan, you may have an individual or combined family deductible. Services applied to your deductible may include blood work, MRIs and hospital stays.

High Deductible Plan Facts

• If you participate in a high-deductible health plan linked to a health savings account, or HSA, your deductible amount can be significantly higher than with a traditional insurance plan. Once you reach the plan's out-of-pocket deductible limit, you do not need to pay for co-pays or prescriptions, according to the U.S. Office of Personnel Management.

Considerations

• Choosing a higher deductible health care plan may reduce your monthly insurance premium. Before scheduling a procedure, you may want to check with the service provider to determine your deductible cost, as the service provider will expect you to pay the full amount when you arrive for your appointment. Your health insurance provider re-sets your deductible amount once per calendar year. If you incur high medical expenses and meet your deductible, you can claim those expenses on your federal income tax return if the total amount exceeds 7.5 percent of your adjusted gross income, according to IRS.gov.