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A co-pay is a set dollar amount an insured patient pays out-of-pocket when visiting a doctor, filling a prescription, having medical lab work or tests performed or receiving other medical treatment, such as therapy.

The amount of an individual’s co-pay is set in their insurance policy agreement, and is usually printed on their insurance card, as well. After a patient meets their co-pay obligation, the insurance company pays the balance of the bill.

Co-pay fees vary, but they’re usually around $25 for visits to a doctor. Prescription drugs often require a separate co-pay, which may have different levels for generic and brand name medications. Emergency room visits may also have their own co-pay, though some insurance companies will waive this if the patient is admitted to the hospital.

Co-pays may prompt someone to think twice before quickly running to an emergency room or doctor’s office for medical help. This can be financially beneficial for the insured and his insurance company, but it can be a problem when someone foregoes needed medical attention just to save a few dollars.

Co-pays differ from co-insurance, which requires the insured party to pay a certain percentage of coverage costs. 

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