How to Know the Difference Between a Copay and a Deductibe

Are you one of many people who find yourself stumbling over the words "Copay" and "Deductible?" For most people, these two words can be quite confusing. In fact, the majority of insured people don't even know what a "Copay" is. When they go into the doctor's office, they think the twenty five dollar payment they are making is their deductible when it is actually a copay.

Instructions

Co-pays and Deductibles Explained

• 1

  Learn the definition of Co-pay:
  The amount an insured person is expected to pay for a medical expense at the time of a doctor's office visit.

  When you go to your doctor for a cold or an annual check-up, this is considered an office visit. Your doctor will require you to pay your Co-pay, which with most insurance benefits is a fixed amount varying between $15 and $40. Please refer to your insurance packet to find out how much yours is, if you don't already know.

• 2

  Learn the definition of Deductible:
  The amount that an insurance policy holder has to pay out-of-pocket before reimbursement begins in accordance with the co-insurance rate.

  A deductible is an amount typically ranging anywhere from $250 to $2500 (sometimes more) based on your insurance policy.

• 3

  Learn the definition of Co-insurance:

  A co-insurance is the percentage of covered expenses that the insurance policy holder has to pay for certain services after their deductible has been met.

  The most common coinsurance level is one in which the policy holder pays 20 percent of the expenses and the insurance company pays 80 percent. This should not be confused as a co-pay since a traditional co-pay is a flat rate fee.

• 4

  Be aware that items such as inpatient hospital stays and surgical procedures are covered with a co-insurance of typically 10 to 30 percent according to the amounts set forth in your insurance policy. Your deductible will apply first if it has not been met. Also be aware that your doctor visits are covered with your flat rate copay.