Re-posted on 5/30/18
A Co-Pay is a set dollar amount you pay for a procedure or office visit (look at your plan summary very carefully). A co-pay is helpful because you’ll GENERALLY pay just the co-pay (unless other procedures are billed by your doctor in addition to the co-pay). For example, let’s say you see your family doctor for a sore throat. If your plan had a co-pay of $35 dollars, you’d pay the $35.
But wait, there’s more:
Sometimes you can be billed more than just a co-pay. For example, let’s say you went to a specialist (specialist co-pays are generally more than a primary care doctor) to have a spot on your skin looked at. The office co-pay may be $50. You’d pay the $50 for the office visit. But if the doctor wanted to remove the spot, he could charge you/your insurance company for a “procedure”. That charge would be in addition to the co-pay. So the procedure could be billed to your insurance company and you’d pay whatever your insurance company had negotiated with the doctor for that procedure.