What is a copay?

RichDayHealthPlans provides Copay type health plans:

  • How does a copay work?  Insurance plans usually employ a copay on doctor visits and drugs.  A copay means that you get the health care provider's service for a reduced amount.  For example, let's say you have a terrible head cold.  If you go to see a doctor, you will typically pay a copay of $25 to $50.  (The actual visit cost the insurance company roughly $65, but you pay the reduced copay amount.) 
  • Why do people like copays?  People like copays because they can see the doctor for a relatively small amount of money that doesn't upset their budget. 

    It is NOT necessary to meet your deductible before the copays can be utilized.
    (This is a frequently asked question.) 

  • How does a drug copay work? Drug copays a somewhat different from doctor visit copays.  Drug copays usually have an annual deductible that must be met before you get to pay the smaller copay amount.  For example, a typical plan will charge a copay of $15 for a generic drug and $35 for a brand-name drug after a $200 annual deductible.  That means that you don't get to pay the smaller copay amounts until AFTER you have accumulated $200 in drug costs.  If you are taking a drug for high blood pressure and perhaps another drug for high cholesterol, those two drugs, if not generic, could run approximately $200 per month.  Therefore, the you will be responsible for the first month and the other eleven months will be covered 100% by the insurance company after your copay.

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