Medical Insurance and Co-pays

If you're shopping around for health insurance, you have probably come across the term "co-payment," also referred to as a "co-pay." Many health care plans offer co-pays as a way to provide coverage choices for policyholders and to help defray costs. Your overall health and financial ability to handle smaller medical expenses play a role in determining the right co-pay level for you.

1. 識別

   • A co-pay is a fixed amount you must pay for a covered procedure under the terms of your health insurance policy. Co-pays are a form of cost sharing between you and the insurance company as you each pay a portion of the expense. Depending on the health plan, you may have several options regarding the co-pay levels you select. Typically, the higher the co-pay you choose, the more of the costs you absorb and the lower your overall premium will be.

   タイプ

   • 特定の種類のカバレッジでは、多くの場合、Co-Paysが利用できます。 For instance, your plan may offer a choice of co-pays for doctor visits, such as $35 for each visit with a maximum of four visits per year. After your fourth visit, you are required to pay the full amount for each subsequent visit. Co-pays may apply to prescription drugs where you pay a fixed amount for brand-name drugs and a lower amount for generic drugs. Certain surgical procedures may also require a co-pay.

   Co-Pay vs. Co-Insurance

   • Some health plans may offer co-insurance as well as co-pays, and the two are often confused. Co-Paysは対象サービスに特定のドルを提供しますが、共同保険はパーセンテージベースで機能します。たとえば、計画に80/20の共同保険機能が含まれている場合、控除可能な制限を満たしたら、あなたと保険会社が80/20ベースで追加費用を共有し、保険会社は80％を支払い、20％を支払うことを意味します。 Once you reach your required out-of-pocket maximum, your insurer will then pay 100 percent of the costs.

   Managing Costs

   • Along with co-insurance and deductibles, effective co-pay management can help you control your health care costs.たとえば、比較的健康で、頻繁に医師を訪問したり、処方薬を服用したりしない場合、保険契約の下で許可されている最高のコートを選択すると、健康保険料を下げるのに役立ちます。 By setting money aside for smaller health care expenses, you may also be able to get by with a higher co-pay amount.