: The annual amount you must pay before your insurance starts sharing costs. Copays typically do not count toward your deductible.

: Copays are generally lower when you visit providers within your insurance network. Out-of-network visits often have significantly higher copays or may not be covered at all.

An (or copayment) is a fixed, predetermined amount you pay out of pocket for a covered healthcare service or prescription at the time you receive it. It is a form of cost-sharing that allows you to pay a smaller portion of the total cost while your insurance company covers the remainder. 1. How Copays Work

: A percentage of the cost (e.g., 20%) you pay after you have met your deductible.

The amount you pay often depends on the type of service being provided: Service Type Typical Copay Level Reason for Variation Encourages routine check-ups and preventative care. Specialist

Tier 1 (Generics) are cheapest; Tiers 2-4 (Brand/Specialty) are more expensive. 3. Copay vs. Other Insurance Terms

It is easy to confuse copays with other out-of-pocket costs, but they function differently:

: The absolute limit on what you pay in a year. Once reached, insurance pays 100% of covered costs. Copays usually count toward this limit . 4. Important Considerations