You may be paying a premium for health insurance, but there are additional expenses that you’re still responsible for. You have cost sharing with the insurance company.
The amount you pay depends on the kind of plan you have. Typically, the higher the premium, the less cost sharing you have. But how does this cost sharing break down?
Copays Are a Flat Rate
A copayment or copay is a flat rate you are charged each time you go to the doctor or fill a prescription. It is paid at the time of service.
Copays are typically different for general practitioners and specialists. For example, you may have a $25 copay for your primary physician and a $50 copayment for your pulmonologist. Any specialist will have that $50 copay. Your health insurance covers the remaining costs of the visit. And the copay is typically paid at the time of service.
The amount of your copay depends on the plan, price, and company you have chosen. Higher monthly premiums have lower copays than those that pay lower premiums. So, you'll want to be aware of that when comparing insurance policies.
Because copays are flat rates, it is not necessary to calculate your copay costs. Copays are usually printed on your health plan ID.
