Hello,

The terms copay and deductible may be confusing for some people, since they are related. A co-payment can be called a point of service payment, something that a patient would give to doctors, other allied health workers, and possibly to labs when they receive service. In contrast, the deductible is the amount of money that a patient must pay before major services are covered, usually things like hospitalizations or surgery.

Copays are part of a patient's payment toward one particular bill and something he usually needs to bring with him at the time of service. Rates vary, depending upon the type of service a person is getting and the type of insurance he has. This is the patient's payment share of that particular visit.

Like copay, deductibles can be highly dependent on the type of insurance a person has. These amounts are usually figured on a yearly basis, however, and once the total is met, his insurance should cover the rest of the payments up to a point. Each year when the insurance policy renews, the patient has to start over, paying again until he's reached the deductible. This is where the difference between copay and deductible gets extremely tricky. In most cases, when a patient has both, insurance will cover their part of things like doctor’s visits before the patient reaches his deductible limit. Therefore, when the new insurance year starts and the patient visits a doctor, he's usually responsible for the copay only and not the deductible amount.


Thanks,

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