Understanding health insurance can be confusing, so Royalton Psychological Associates, LLC. has put together this explanation of insurance copayments (co-pays).
What is a co-pay?
A fixed amount (example $20) you pay for a covered health care service after you have paid your deductible.
For example, your health insurance plan’s allowable cost for a doctor’s office visit is $100. Your copayment for a doctor visit is $20.
• If you have paid your deductible: You pay $20, usually at the time of the visit.
• If you have not met your deductible: You pay $100, the full allowable amount for the visit. You pay $20 at the time of visit and after cleared through insurance, you are billed for remaining $80.
Are co-pays always the same amount?
Copayments (or co-pays) can vary for different services within the same plan, ex. Primary Care Provider visits compared to visits to Specialists.
How can I find out details about co-pays for my plan?
A co-pay can vary greatly, from $10.00 per appointment to over $50.00 per appointment depending on your plan. Plan benefits can also vary from year to year, so it is important to check with your insurance provider to see if there are any changes (the phone number and/or member portal website listed on the back of your insurance card provide easy access to this information). Royalton Psychological Associates, LLC. will not know your co-pay until we verify your benefits during your first appointment, so we recommend checking with your insurance provider first if you are unsure of your plan benefits.