co-payment


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co-payment

Managed Care That portion of a claim or medical expense that a health plan member must pay out-of-pocket for specific medical services–eg, hospital care, drugs, office visits, etc; the insurer pays the remaining portion

co-payment

, co-pay (ko?pa'ment) (ko'pa')
The fee insured persons must pay, in addition to their health insurance premiums and deductibles, for specific medical services such as emergency department visits, appointments with primary care providers, laboratory studies, prescriptions, or x-ray examinations.
See: coinsurance
References in periodicals archive ?
The report says that 50% or so of consumers who do not utilize health care services extensively are subject mainly to premiums and plan fees but do not often pay co-payments and rarely must meet deductibles; on the other hand, consumers with chronic conditions and those who otherwise utilize plan services frequently pay not only premiums and plan fees but also make frequent co-payments and often become subject to deductibles and plan coverage limits.
Even though his premium will drop 10 percent, the sergeant guaranteed he would pay for it "on the back end'' with the higher co-payments, medical costs and prescriptions.
Even the AMA and other health groups are against the co-payment because it would prevent Aussies from visiting their GPs and could lead to a spike in emergency admissions.
Practically everything in life is a form of co-payment.
He suggested that implementing a co-payment would help inmates with doing just that.
A control group whose co-payments didn't change switched to a cheaper drug in 2 percent to 17 percent of cases and stopped taking them in 6 percent to 19 percent of cases.
A co-payment of $2 or $3 looks like small change to most people, including those covered by private insurance plans, which often require much larger co-payments for prescription drugs.
The district court granted a permanent injunction against a proposed prison co-payment program that would have required the prisoners to pay 25 percent of the cost of their kosher diet.
Some plans offer full payment, while others ask patients to contribute a small co-payment.
At issue was whether an insured's co-payment should be based on the health care provider's standard charges or on the actual discounted price negotiated by BCBSO with the provider.
According to a 1994 report in Corrections Forum magazine, a similar co-payment program in Mobile, Alabama, showed a 50 percent reduction in inmate visits to the clinic.
Participants using a particular drug for the first time are required to pay a $15 co-payment for brand-name or $5 for generic drugs, and they receive a 30-day supply of the drug.