Copay (copayment)
Updated September 30, 2026
Definition
A fixed dollar amount you pay for a covered service, like $30 for a doctor visit. The amount can differ for visits, drugs, lab tests, and specialists.
A copay, short for copayment, is a set dollar amount you pay for a covered service. Your plan pays the rest of the allowed amount. You often pay it when you check in for the visit.
Copays can differ within the same plan for visits, drugs, lab tests, and specialists. On many plans, you pay a copay after you've met your deductible. Before that, you may owe the full allowed amount. Your plan's Summary of Benefits and Coverage shows which applies.
For example, say your copay for a specialist visit is $50 and the allowed amount is $180. You pay $50 and your plan pays $130. If you paid at the visit, your bill should show that payment as a credit. To check it, see our guide to medical bill vs. EOB.
Related terms
Guides that use this term
- GuideMedical bill vs. EOB: how to compare them line by lineYour bill and your EOB should tell the same story. Here's how to compare them in 20 minutes, with a worked example and what to do if they don't match.
- GuideHow to choose a health insurance plan and avoid big billsCompare health plans by total yearly cost, not just the premium. Check networks, doctors, drugs and the SBC, with a worked example and 2027 deadlines.
Sources
- Copayment (glossary), HealthCare.gov. Accessed September 30, 2026.
- Health insurance terms you should know, Centers for Medicare & Medicaid Services. Accessed September 30, 2026.
This is general information, not legal or medical advice. Rules can depend on your plan and your state. Romi Care isn't an insurer, law firm, collection agency, or government program.