Don’t get “Co-Payment” and “Co-Insurance” confused. Remember, “Co-Insurance” is a percentage (20%) of approved medical expenses that you pay and there is a limit (maximum out-of-pocket). A “Co-Payment” is completely different.
In Health Insurance A “Co-Payment” Is Not “Co-Insurance - Know The Difference.If you take any prescription medications, you already know how a “Co-Payment” works - you may pay $10.00 for generic drugs and $20.00 for named brand drugs (whatever your health insurance policy requires). |
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Some health insurance policies are designed to require a “Co-Payment” for almost everything, like:
- Each Hospital Admission - $ 500.00 Co-Payment
- Outpatient Surgery - $ 250.00 Co-Payment
- Emergency Room - $ 100.00 Co-Payment
- Doctor Visit - $ 20.00 Co-Payment
- Specialist Visit - $ 40.00 Co-Payment
- Generic Prescription Drugs - $ 10.00 Co-Payment
- Name Brand Prescription Drugs - $ 20.00 Co-Payment
Other health insurance plans may have the “Co-Payments” for doctor visits and prescription drugs and use the “Deductible” and “Co-Insurance” arrangement on all other approved medical expenses.
If your health insurance plan requires “Co-Payments”, these payments must be made each time that particular medical service is required. Remember, “Co-Payments” do not reduce your maximum out-of-pocket expenses.
- Do you know your health insurance plan’s “lifetime maximum”?
- Do you know how health insurance companies deal with “pre-existing” health conditions?
- Does your health insurance plan have adequate “co-insurance” provisions?
- Do you understand that your health insurance premium could be lowered by increasing your “deductible”?

Other Insurance Maze Articles of Interest
- Do You Have The Insurance Coverage You Think You Have?
- Is Your Commercial Vehicle Insured On Your Personal Auto Policy?
- Medicare Supplement Insurance & Medicare
- Home Insurance/Home Inventory-A Good Combination
Glossary Insurance Terms: |A-C|D-H |I-M|N-P|R-T|U-W|
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February 2, 2008





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