what is the difference between a deductible and a copayment.. or are they the same thing?

Answer 1

A deductible is what you have to pay before the insuror pays anything. A copayment is the percentage the insurance company will pay after you have met your deductible.

Answer 2

Not the same.

A copayment is a set dollar amount that is your portion of the visit to pay each time you see the doctor.

A deductible is a predetermined dollar amount (anywhere from $100 to $2500 I've seen) in payable charges that you must pay out of pocket before the insurance will pay a dime. NEVER pay on your deductible until your insurance has been billed. The insurance will tell the provider how much to charge you and track how much is put to your deductible and when it is met.

Coinsurance often goes with a deductible - it's a formula used by insurances to determine how much of the bill you pay - anywhere from 5%-30%. Again, never pay before your insurance is billed.

There are plans that have both copays and deductible/coinsurances - sometimes for the same thing, some times for different portions. Always know what you pay copays on and what is eligible for your deductible.

Answer 3

They are NOT the same thing. The deductible is the amount out of your pocket, before insurance kicks in. The co-payment is AFTER the insurance kicks in, the portion you still have to pay.

Example: You have a $100 deductible and a $25 co pay. If you visit the doctor, and the bill is $50, you pay the full $50. If you visit a second time, you pay a second full $50. If you visit a third time, well, you've MET your $100 deductible, but you pay $25 - the co pay.

Hope that helps.

Answer 4

A co-payment is what you have to pay for each doctor's visit or prescription. It does not count towards the deductible at all.

A deductible is what you have to pay (per year) before the insurance will kick in and pay their part. Usually it does not include doctor visits.

Say you have a $500 deductible and the insurance will pay 80% after the deductible is met. If you have an ER visit, and the charges are $750. You will pay the first $500 for your deductible and the insurance will pay 80% of the remaining $250.

Answer 5

everyone is on the right track, but not exactly right.....
copayment - this is a set dollar amount that you have to pay for services. this dollar amount is determined by your employer who negotiates plans for their employees. example - a doctors office visit is $150, the insurance allowed amount is $100, you pay your $25(example) copay and the insurance company pays the additional $75. this is a set dollar amount.
deductible - this is the amount of money that you are responsible for medical services before your insurance plan kicks in (usually at a percentage). this starts again every year. if you have a $500 deductible for 2007 and you have 2 doctors visits equalling $100 in allowed services, then you have to pay the doctors office after the claim is submitted and the insurance co processed the claims w/ their discounts.
the entire plan design, meaning whether you pay a copay or ded is designed by your employer if your insurance is thru your employer. they can change the design of the plan every year if they are trying to keep costs under control.

Answer 6

as a way to keep costs under control, health insurance companies have copayments, an amount paid on each and every vistit to a medical practitioner or facility, and deductibles-an amount the insured must pay before any claims will be paid by the insurer. there are many types of plans and the choice should be driven by the amount of medical care one needs. for instance, a young, healthy person would be best served by a high deductible plan that would have a much lower premium. that way, you're only paying if you need medical care. medical and dental expenses that are unreimbursed by insurance may be tax deductible.

Answer 7

A co-payment is the amount you are required to pay EACH time you have the service, regardless of its cost. A deductible is the amount you are responsible for paying before the insurance company will pay. If you have a $50 emergency room co-payment and end up in the emergency room, you will have to pay $50.00. Then, you may also have a $200 deductible to meet also before the insurance company will pay. In this instance you will be stuck paying 250.00. Hope this helps.

Answer 8

The doctors that you go to will charge you a copayment for the visit. Thats a small fee based on the insurance.
The deductible is the total amount you spend on any medical service or dental service before the insurance will pay the remainder of the service.
For example, if your dental plan has a $1,000.00 deductible, it means that you must spend that amont on the dental before the insurance would kick in.

Answer 9

wait no... that's wrong!
she's rite about the deductible... that's how much you're responsible for upfront... but copayment is also something ur responsible for upfront... deductible usually applies to large claims like hospiital stays etc... copayments are what ur responsibole at check out when u see ur doctor or get prescriptions..
so look at it like this.. deductibles are what the insurance comps take out from the total reimbursement when they settle claims... copayments are what u pay upon service witht he rest being paid by the ins co at settlement witht he provider...
hope that helps...