The cost sharing arrangement in which the insured person pays a specific charge for certain services. For example, a patient may pay $10.00 for a visit to the Doctor's office. This amount is the consumers co-payment.
Part of charges the patient is responsible to pay until a certain maximum amount is paid. Usually paid directly to the provider at time of service
A flat, pre-set fee paid by an insured for office visits, drugs, and other medical services as member of an HMO or preferred provider service. These co-payments are normally a small fraction of the overall cost and act much like a service charge or handling fee.
A cost-sharing arrangement of a health plan in which the patient pays a fixed fee for a specific service (such as $10.00 for an office visit). This fee does not vary with the cost of the service. Also referred to as co-insurance.
An amount the insured must pay, after any deductible.
a cost-sharing arrangement in which you pay a fixed amount for a specific service, such as $10 for an office visit. You are usually responsible for payment at the time the healthcare is rendered.
Fixed payment (usually in the $5 to $50 range) required for certain medical services, i.e. office visits, hospital admissions, and therapy sessions.
the percentage of the allowable amount, or low, fixed fee that members pay for covered services when receiving benefits. Co-payments are the member's share of the cost of covered services. With PPO plans, most percentage co-payments only apply after you satisfy a plan deductible. Most HMO co-payments apply right away, without any deductible.
A nominal fee charged to patients to offset costs of paperwork and administration for an office visit or pharmacy prescription. Back to the top of the page
A type of cost sharing where the insured party is responsible for paying a fixed dollar amount per service.
The portion of the cost of services that is to be paid by the service consumer.
A type of cost-sharing which requires the insured or subscriber to pay a specified flat dollar amount, usually on a per-unit-of-service basis, with the third-party payer reimbursing some portion of the remaining charges.
The amount a health plan beneficiary is required to pay for certain medical services. Under the Medicaid program, co-payments cannot be charged for family planning or emergency services and certain populations (pregnant women, children under 18 and some hospital or nursing home patients) and are exempt from co-payments. Co-payments are often charged for each doctor's visit or prescription filled. They also may be charged for inpatient and outpatient hospital services.
Co-payment is a dollar amount (in 2005 this is usually $20) that you need to pay each time you see your PCP or specialist within the network
a fixed amount the member pays every time he/she visits a health plan provider and receives services. The range of co-payment varies based on the type of service and the health plan coverage.
Specified share of total liability, for example, a specific dollar amount per hospital day or office visit, for which the insured is responsible.
A type of cost sharing where insured persons pay a specific flat amount per incident of service.
The amount you pay for each medical service, like a doctor visit. A co-payment is usually a set amount you pay for a service.
That portion of a claim or medical expense that a member must pay out of pocket. Usually a fixed amount, such as $5 in many HMOs.
A specific charge you pay for a specific dental service. For example, you may pay $10 for an office visit or $5 for a prescription and the dental plan covers the rest of the dental charges.
A co-payment, or co-pay, is a fixed-dollar amount insured persons pay each time they seek care or purchase covered items, such as office visits or prescription drugs. Co-pays sometimes apply to inpatient hospital stays. Health plans usually have separate co-pay requirements for prescription drugs.
The part of the medical bill that is not covered by a patient's health insurance policy and must be covered out of pocket by the patient. It is usually a flat amount, such as $10 for an office visit.
A cost-sharing arrangement under which a covered person pays a specified dollar amount for a specified service, such as $10 for a prescription or $20 for a doctor's office visit.
The insured's share of covered health insurance benefits, usually a flat, preset fee.
Amount of money you, as a patient, would be expected to pay for a service. For example, doctor office co-pay of $15. At each doctor visit, one would be expected to pay $15.
A cost sharing arrangement in which a person pays a specific charge for a specific medical service -- say $20 for an office visit or $10 for a prescription.
A type of cost sharing where insured persons pay a specified fee for service or a percent of the amount allowed as reimbursement for a covered service. Also referred to as "co-insurance".
a flat fee you pay for certain medical expenses, such as prescription drugs.
a cost-sharing arrangement under which a beneficiary pays a specified dollar amount for a prescription drug
a fee you pay yourself in addition to that which is covered by your insurance)
a fixed amount that the insured has to pay each time they visit the doctor
a fixed amount you have to pay each time you visit the doctor
a fixed dollar amount or a percentage that you pay for each visit/service
a fixed dollar amount that members must pay each time they receive a specified service
a flat dollar amount the participant must pay for medical services or prescription drugs at the time they are provided
an agreed amount paid by members towards the cost of each day spent in hospital
an amount established by individual insurance plans and is usually specified on the insurance card
an amount that a member pays towards the cost of Hospital Treatment Charges and has been set by MBF to help contain costs
an amount that you pay towards the cost of hospital treatment charges and has been set up by the Fund to help contain costs
a patient's share of a health-care bill
a percentage of the amount of covered expense you are required to pay
a percentage you pay of the remaining charges after your deductible
a per-service fee you pay
a portion of your health care expenses that is not covered by your insurance
a set amount a person insured under a medical policy has to pay per visit to a doctor, hospital or other facility
a set amount that a patient is responsible for at each visit
a set amount you agree to pay each day towards your hospital accommodation
a set fee the member pays to providers at the time services are provided
a small amount of money you pay towards the cost of your care
a specific amount of money that an insurance company requires be paid by the patient at the time of service
a stated amount or percentage that must be paid by the member along with each doctor visit, medical procedure, or prescription
The dollar amount the policyholder pays at each visit for a medical service; it varies according to each insurance policy.
Payments made by the insured or beneficiary of insurance to help finance the cost of benefit plans. A means of cost sharing.
A flat fee for a service, paid by the insured as his or her share of the cost of the service. The insurance plan covers the rest.
A cost sharing part of your bill that is your responsibility to pay. Also known as co-pay.
The flat amount you pay for eligible expenses, such as office visits and exams. This is usually $5, $10 or $15 for most providers, but can be up to $700 for in-patient care. Used in Preferred Provider Organizations (PPOs), Health Maintenance Organizations (HMOs) and Prescription Plans. In some plans, the Co-Payment can be a percentage of the fee, as determined by the insurer, instead of a flat amount.
A cost sharing feature where the Member pays a fixed dollar amount for the cost of medical care after the deductible has been satisfied. An example of a common co-pay is $10 per physician office visit. Co-payment may also be defined as a Coinsurance.
A small charge paid at the time a medical service is received. It does not accumulate toward a plan's deductible or out-of-pocket maximum and is designed to discourage utilization.
A cost-sharing arrangement in which an insured, as part of the total cost of a service or supply, pays a specified amount for a service or supply (for example, $5 for prescription drugs). The insured is usually responsible for paying the provider the co-payment when the medical service or supply is provided.
The amount you pay each time you receive services. In many plans, the copayment is a flat amount, such as $10 or $15 for an office visit with a medical provider.
A way in which the enrollee shares in the cost of health care. The benefit plan requires the enrollee to pay a flat dollar amount per unit of service. An example of a common co-pay is $10 per physician office visit.
The fee you pay at the time of medical services in accordance with Elderplan.
Used interchangeably with coinsurance. Co-payment is usually a set dollar amount rather than a percentage.
The set amount that you pay each time you use a particular service. For example, if your insurance plan has a co-payment of $5 for each doctor visit, you will pay the doctor $5 at each visit and the insurance company pays the rest.
Refers to the payment that the insured must pay at the time of an office visit..
Co-payment is a predetermined fee, in addition to what health insurance covers, that an individual pays for health care services.
a cost-sharing arrangement in which an insured pays a specified charge for a specified service, such as $10 for an office visit. The insured is usually responsible for payment at the time the service is rendered. This charge may be in addition to certain coinsurance and deductible payments.
A kind of cost sharing where you pay a pre-set, flat amount for each service. In a Medicare drug plan, for example, you might pay $10 for each prescription you receive and the plan would pay the remaining cost of the drug. See cost sharing.
in a health plan contract, the portion of covered medical costs that is paid by the patient. In a typical plan, the patient's co-payment may be based on a percentage or a flat fee.
The fixed dollar amount that your policy requires you to pay as your share of the cost of certain services each time you receive care.
A specified dollar amount or percentage of covered expenses which a health care policy/contract or Medicare requires a covered person to pay toward eligible medical bills.
the portion of a medical bill that a patient pays.
The fixed fee that must be paid to the provider at the time services are provided, such as the pharmacist for a prescription.
A cost sharing where you pay a preset flat amount for a service, and the plan pays the rest.
A specified dollar amount or percentage of covered expenses that an insurance policy or Medicare requires a beneficiary to pay toward eligible medical bills.
An amount the employee is responsible for paying at the time services are obtained. This is a fixed amount for specific services regardless of the total charge for the service.
The amount a plan member has to pay--usually $5 to $15-- every time he or she visits an affiliated physician or receives services.
The amount that someone must pay out -of -pocket when they receive some health services covered through Medicare or purchase a covered prescription drug. Copayments are stated as flat dollar amounts and vary according to the type of service provided.
A specific charge you pay for a specific medical service. For example, you may pay only $15 for an office visit or $10 for a prescription drug and the health plan covers the rest of the medical charges.
A fixed dollar amount paid by the enrollee each time certain covered services are received.
A specified dollar amount that a patient is required to pay each visit to a health care provider before the charge is considered for benefits by the insurance company.
The portion of the cost of care an insured person is required to pay, while the person's insurance plan usually, but not always, pays for the majority of the cost.
Cost-sharing arrangement in which the patient is required to pay a specific dollar amount for the health care services received (e.g., $10).
a set or flat fee that a consumer is obligated to pay for specific healthcare service. This amount is separate from the fees being covered by the health insurance company. For example, most Health Maintenance Organizations - HMO's use a ten-dollar co-payment for every doctor office visit, regardless of the type or level of medical services received during the actual stay.
the amount an insured individual must pay toward the cost of a particular benefit. For example, a plan might require a $10 co-pay for each doctor's office visit.
the part of the total cost of a medical bill that you are responsible for paying
A specified flat dollar amount a member pays for a specific service, usually when seeing a PPO physician. For example, if the office visit co-payment is $10 and the office visit is $70, the member would pay $10 to the physician at the time of service and the plan would pay $60, less the PPO discount. This is only true if the plan pays 100 percent benefit. Some plans may only pay 90 percent of the charge. Also referred to as a front-end deductible.
A provision in insurance policies requiring the participant to pay a flat fee for certain services.
Your insurance plan will list basic services such as office visits and prescriptions for which you must pay a fee usually set between $5 and $25. The insurance company will cover the rest of the bill.
A set fee members must pay each time they use a particular benefit.
Cost-sharing arrangement in which the insured person pays a specified share of the charge for a specified service, such as $10 for an office visit. The insured person is usually responsible for payment at the time the health care is rendered.
The portion or percentage of the Medicare-approved amount that a beneficiary is responsible for paying.
This is just another way of sharing medical costs. With a Co-payment, you pay a flat fee every time you receive a medical service (for example, $5 for every visit to the doctor). The insurance company then pays the rest.
refers to a flat fee that plan members have to pay for each doctor visit or service. For example, some HMOs require a $10 "co-pay" for each office visit, regardless of the type of services rendered. Generally, co-pays are for office visits, prescriptions, or hospitalization.
A flat fee paid out of pocket for medical services, usually at the time the service is rendered. Usually applies to physician office visits, prescriptions, emergency or hospital services. It also applies to patients who use a prescription drug card. Biologics collects the co-payment and files the rest of the cost of the drugs to the insurance provider.
Fees stated as a set dollar amount payable at the time Covered Services are rendered by a Member to a Health Professional for certain services.
The specific amount a recipient/guarantor must pay prior to rendered medical services. Carrier determines this amount.
The specific dollar amount or percentage required to be paid by or on behalf of a member in connection with an insurance benefit.
The amount you pay after satisfying your deductible. In some plans, this is a small fixed fee paid at the time you receive service.
CLOSE The charge you must pay for certain health services covered under your plan. You are responsible for paying the co-payment directly to the provider of the health service at the time of service or when billed by the provider. Co-payments can be a flat dollar amount or a percentage of eligible costs. Your in-network co-payment is the charge you pay to providers who are in your health plan. Your out-of-network co-payment is the charge you pay to providers who are not in your health plan.
The patient's part of the bill paid at the time of service. Co-payments are usually flat fees for a particular service (e.g. $15 per doctor visit or $20 per prescription).
The set dollar amount an insured person is required to pay for each medical service received, or each doctor or hospital visit. Under a co-payment schedule, the insured pays only the co-payment for the service received; the health insurer pays the rest of the fees charged.
A cost-sharing arrangement in which the HMO enrollee pays a specified flat amount for a specific services (such as $2.00 for an office visit or $1.00 for each prescription drug). The amount paid must be nominal to avoid becoming a barrier to care. It does not vary with the cost of the services, unlike co-insurance which is based on some percentage of cost.
"A cost-sharing arrangement in which a member pays a specified charge for a specified service (e.g., $10 for an office visit). The member is usually responsible for payment at the time the service is rendered."
A fixed, per-service dollar amount that the consumer pays. For example, your plan may require that you pay $10 per prescription and/or $20 for each visit to a doctor's office.
A specified dollar amount that a member must pay out-of-pocket for a specified service at the time the service is rendered.
The amount that you must pay a health care provider at the time of service.
The portion of charges you need to pay your provider every time you receive a medical service, usually a fixed amount, e.g., $10 for prescription, $20 for every doctor's visit. The insurance company pays the rest of the charges.
A co-payment (co-pay) is a fixed amount you pay if enrolled in the TRICARE Prime option and services are provided to you by a TRICARE authorized provider. Sometimes the terms co-payment and cost-share are used interchangeably. In fact, co-pays are a set amount based upon the service provided whereas cost-shares are a percentage based upon the TRICARE allowable charge.
Co-payment is a predetermined (flat) fee that an individual pays for health care services, in addition to what the insurance covers. For example, some HMOs require a $10 "co-payment" for each office visit, regardless of the type or level of services provided during the visit. Co-payments are not usually specified by percentages.
A small set fee you pay for a service (e.g. $5 co-payment for a visit to a doctor). Members typically pay a co-payment ranging from $5-$15 every time they visit the doctor, have test done, or have a prescription filled.
amount not covered by insurers the patient is responsible for paying.
(co-pay): the fixed amount you pay for every medical service, independent of any deductible.
Some plans have a benefit where there is a set amount you pay when visiting certain providers. This amount is the Co-payment.
The contractual provision that requires you to pay a specific charge for specific service, usually when you receive the service. A co-payment usually applies to office visits, prescriptions, emergency or hospital services.
Another way of sharing medical costs. You pay a flat fee every time you receive a medical service (for example, $20 for every visit to the doctor). The insurance company pays the rest. This benefit is usually available without having to satisfy the plan deductible.
The calculated amount the parent must pay toward the cost of child care. DSHS pays the remainder up to a set maximum rate. All clients receiving child care through DSHS have a co-payment.
A flat fee paid out of pocket by the patient for medical services, usually at the time the service is rendered. This usually applies to physician office visits, prescriptions, and emergency or hospital services.
The dollar amount a patient pays when services are received. A visit to a primary care physician might require a co-payment of $10, a visit to a specialist $20 and a prescription $10.
A payment made by the user at the time of service as part of the total payment for that service and any associated product.
Your out-of-pocket payment when you visit your physician or other healthcare provider (i.e. a $5 co-payment applies to Aetna HMO).
A specific payment by the covered person at the point of each health service visit. It does not accumulate like a deductible and is not subject to an out-of-pocket maximum.
Most people have this system within their policy. Essentially, it’s another way of sharing medical costs. You pay a flat fee every time you receive a medical service (for example, $5 for every visit to the doctor). The insurance company pays the rest.
A set amount that a member pays out of pocket for healthcare services at the time the services are rendered.
A charge you pay for medical services. Your health care plan covers the remaining medical charges. As an example, you may pay $10.00 for an office visit or a prescription.
The out-of-pocket amount you pay every time you receive a medical service (for example, $5 for every visit to the doctor). The insurance company pays the rest.
The amount the consumer pays for health care in addition to what the managed care organization pays. For example, many non-Medicaid HMOs require $10 co-pay for each doctor's visit.
The amount you'll have to pay each time you visit a health insurance provider.
A percentage of medical costs which the patient is required to pay, usually up to a certain limit.
A patient's share of the bill. In traditional insurance plans, patients typically must pay a percentage of the total cost of services received. In managed care plans, patients typically pay a small fee each time they visit their doctor, no matter the cost of services received.
A dollar amount that a person must pay out-of-pocket for a medication or other health service. For example, a PDP may ask for a $3 co-payment for each generic prescription and $5 for brand name prescriptions. Co-pays may be further tiered by PDPs to discourage use of more expensive drugs.
An amount established by the insurance company as the patient's responsibility of billed fees.
A portion of a bill that is the responsibility of the patient and that applies when certain services are rendered. The amount usually varies by the nature of the service and the amount of the bill. This payment supplements the payment that is made by a third-party payer.
Refers to the payment that must be made at the time of service for Physician Office Visits.
The percentage of covered medical expenses and allowable fees for services payable by the member.
The insured individual's portion of the cost, usually a flat predictable dollar amount, like $10 per office visit, for example. Under many plans, co-payments are made at the time of the service and the health plan pays for the remainder of the fee. Generally, a plan will either require co-payments without a deductible, (HMO, POS plans) or co-insurance and a deductible, (indemnity, PPO plans).
In some Medicare health and prescription drug plans, the amount you pay for each medical service, like a doctor's visit, or prescription. A copayment is usually a set amount you pay. For example, this could be $10 or $20 for a doctor's visit or prescription. Co-payments are also used for some hospital outpatient services in the Original Medicare Plan.
The flat free you pay for services in the POS/HMO health Care plan, usually for each office visit or each hospital stay.
A fixed amount an insured pays for covered services or prescriptions.
A fixed amount paid by the member for covered services at the time they are rendered or for prescription medications.
The dollar amount some Medicare beneficiaries are required to pay for each medical service, such as a doctor's visit.
Mechanism, used by insurers to share risk with policyholders and reduce moral hazard, which establishes a formula for dividing the payment of losses between the insurer and the policyholder. For example, a co-payment arrangement might require a policyholder to pay 30% of all losses while the insurer covers the remainder.
A fixed payment required for required for certain medical services, i.e. office visits, hospital admissions, and therapy sessions. Co-payments are usually specified as dollar amounts.
Employee's payment of a portion of the cost of both insurance premiums and medical care.