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Glossary

Copay

Also known as: Copayment

Medically reviewed, last updated

A copay is a fixed dollar amount you pay for a covered health service at the time of care, typically $10-$50 for a primary care visit, $25-$75 for a specialist visit, and $5-$20 for generic prescriptions. Copays are separate from your deductible and apply per visit.

Copays for mental health and primary care must be at parity with copays for medical/surgical care under the federal Mental Health Parity and Addiction Equity Act. If your plan charges a $75 mental-health specialist copay vs $40 for a medical specialist, ask the plan to justify it; this may be a parity violation.

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Medical Disclaimer

This glossary entry is for informational and educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider with questions about a medical condition.