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What is a copayment in health insurance?

Co-payments for health insurance policies

All about Careers by All about Careers
9 April, 2022
in Career Industry
0
Co-payments for health insurance policies

The co-payment in health insurance is a modality that makes it possible to reduce the cost of health insurance policies in exchange for paying certain amounts when using the services included in the coverage. There are different types of co-payment, both in their amount and their application.

To explain a co-payment in simple words, we could say that it is an amount of money that is paid to cover the medical expenses of the insurance policy.

How does the copayment work in health insurance ?

The mechanism of copayments in health insurance is very simple to understand: an amount of money is established as a fixed deductible. This amount of money must be paid after receiving the required healthcare service. Expenses exceeding this amount are borne by the health insurance company.

For example, the co-payment for medication is $25. The cost of the prescription drug is $50. The patient pays the first $25 and the insurer pays the remaining $25.

It is important to keep into account that not all services and coverages apply the same co-payment. Continuing with the example of the drug, if it is generic it may have one co-payment amount, and if it is brand name it may have a higher one.

Similarly, health services have different co-payments. A health insurance company may charge different amounts depending on the specialty.

Another format that co-payments also take is to combine fixed amounts with a percentage. For example, care from a health professional may require a co-payment of $100 plus a percentage of the total cost. The insurer will cover the rest.

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Are insurance co-payments worthwhile?

This is an interesting debate and there is no easy answer. Co-payments reduce the final cost of the insurance policy.

In other words, a health insurance policy without a co-payment will be more expensive than one with a co-payment for the same coverage. However, the difference is that with the first policy we do not have to pay additional amounts, and in general the insurance will cover all expenses.

The decision as to whether or not it is worthwhile to use this type of health protection formula depends on the protection needed.

For a person with little average expected use of insurance coverage, it is worth using the co-payment. The cost of the policy will be cheaper, and when it comes to using health services, it will be possible to control expenses more carefully.

For families or individuals, with a certain degree of foresight in the use of health services, co-payments may not be worthwhile. It should be considered that these costs accumulate over the course of the year and are applied each time the service is used.

In conclusion, this is an interesting formula, which we should take into account in our health insurance, but it may not be suitable for everyone. As always, it is necessary to study the proposal in more detail and analyze the benefits and drawbacks for our pocket and our health coverage.

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Contents

  • 1 How does the copayment work in health insurance ?
  • 2 Are insurance co-payments worthwhile?

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