Bills and insurance
What Is a Copay in Health Insurance?
Copay · say it: KOH-payAlso written: copayment, co-pay, fixed fee
Short answer
A copay is a fixed amount you pay for a covered health service or prescription, such as a set fee for each doctor visit.
What it means
Many insurance plans set a flat fee for certain services, such as primary care visits, specialist visits, urgent care or prescriptions. That flat fee is the copay, and the insurer pays the rest of the allowed amount.
Copays can differ by type of service and by medicine tier. Depending on the plan, copays may apply before or after the deductible is met.
Copays usually count toward your out-of-pocket maximum. Your plan documents list the copay for each type of service.
Where you may see it
- Insurance cards and plan summaries
- Explanation of benefits (EOB) statements
- Pharmacy and clinic receipts
📄 How it looks on a report
Specialist visit copay: $40.00
🙅 What it does not mean
- A copay is not the total cost of the visit; it is your fixed share.
- Paying a copay at the visit does not always mean you will owe nothing else later; other charges can apply.
- Copay and coinsurance are different; coinsurance is a percentage, a copay is a fixed amount.
🗒️ Questions to ask your doctor
🧾 Reports where you will see “Copay”
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🔗 Read more from trusted sources
- “Copay” on MedlinePlus ↗
US National Library of Medicine
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