Your health plan may require a copayment (or copay) whenever you receive a medical service.
A copayment (or “copay”) is a monetary charge that your health insurance plan may require you to pay in order to receive a specific medical service or supply. For example, your health insurance plan may require a $15 copayment for an office visit or brand-name prescription drug. After you make the $15 copayment, your insurance company generally pays the remainder of the charges.
Watch our copay video
To gain a better understanding of what copays are and how they may affect you, watch our copay video.
View the infographic below for more details on copay.
Percentage of health plans that offer copays
In February 2014, eHealth looked at 947 major medical health plans available in 25 cities across the United States. This research was conducted to determine the percentage of plans that cover doctor’s visits with a copay at each metallic level, as well as the percentage of plans that provide coverage for people who wish to see an out-of-network doctor.
The average premiums and deductibles used in the study were calculated using a 29-year-old individual, and the data is weighted to reflect the total number of plans available in each market and at each metallic level.
eHealth’s 25-City Analysis:
|Health plan’smetallic level||Average premium||Average deductible||% of plans covering doctor’s visits with a copay||% of plans covering non-emergency out-of-network visits||Total plans|