Copayment definition

Copayment means that you pay a fixed amount each time you fill a prescription.

Copayment means a specific dollar amount that a patient must pay for certain services before the Fund will be financially liable for covered expenses.

Copayment means the fixed dollar amount, established solely by AvMed, that a Member must pay once any applicable Deductible has been met, for certain Covered Services rendered by a Health Care Provider at the time the Covered Services are received. The Copayment is a portion of the Allowed Amount for the Covered Service, or a portion of the Maximum Medicare Allowable or Average Wholesale Price, for the Covered Service.

Examples of Copayment in a sentence

• If the contracted rate for a Covered Benefit is less than the Copayment, you pay only the contracted rate.

• A Copayment, Coinsurance or Deductible may apply for these services.

• If your benefit plan includes a Deductible, you may be required to satisfy the Deductible prior to paying the Copayment amount.

• Once you meet the Deductible for Self-Only Coverage, Covered Benefits subject to that Deductible are covered for you by Plan, subject to any applicable Coinsurance or Copayment, for the remainder of the Calendar Year.‌‌‌ Once you meet the Out-of-Pocket Maximum for Self-Only Coverage, Sharp Health Plan covers Covered Benefits at 100% for you for the remainder of the Calendar Year.

• For up to a 30-day supply of a Tier 2 drug on the Formulary, you pay one Drug Tier 2 Copayment or Coinsurance.

More Definitions of Copayment

Copayment or “Copay” shall mean a dollar amount the Participant pays for health care expenses. In most plans, the Participant pays this after he or she meets his or her Deductible limit.

Copayment means an amount an enrollee must pay in order to receive a specific service which is not fully prepaid.

Copayment means a dollar amount fixed as either a percentage or a specific dollar amount per prescription payable to the pharmacy at the time of service. Copayments are specifically stated in this section. Copayments are not payable by the Plan and do not serve to satisfy the Medical Benefits Deductible. However, Pharmacy Copayments do apply towards the combined Out-of-Pocket Maximum for Medical Benefits and Pharmacy Benefits and after satisfaction of the Out-of-Pocket Maximum, Copayments will no longer apply for the remainder of the Benefit Period.

Copayment means the portion of BCBSM's approved amount that the Member must pay for Covered Services under the terms of a Certificate. This does not include a Deductible.

Copayment means a monetary amount, specified by the Director, that a member pays directly to a contractor or provider at the time covered services are rendered.

Copayment means the amount the Member pays when a Covered Service is received.

Copayment means the fixed dollar amount a member pays to a health care provider at the time a covered service is provided or the full cost of a service when that is less than the fixed dollar amount.