HomeCommunity NewsWhat’s the Difference Between Deductible and Copayment?

What’s the Difference Between Deductible and Copayment?




By Jay Dorso

In the world of Health Insur-
ance + Medicare it is very im-
portant to understand the differ-
ence between

Deductib es

and Copay-
ments. The

better you un-
derstand the

d i f f e r e n c e
between the
two the more
comfortable you will feel about
our Healthcare coverage. It is
important to know how much
you’re required to pay toward

the cost of your health care ex-
penses, when the payment is due,

how much of the bill does your
health plan pay etc…
What is a Deductible?
A deductible is a fixed set

amount determined by your in-
surance company that you pay

each year before your insurance

starts to work. Once you pay that
amount your insurance policy

will now pay their required por-
tion of your bills. Deductibles

can be family or individual de-
pending on your policy.

Let me give you an example,
if you have a $1,000 deductible

and you need to see your Prima-
ry Care doctor Feb 10 th because

you’re not feeling well. Let’s as-
sume the bill is $100. You would

pay the full amount because you
haven’t reached your financial
responsibility yet of the $1,000
deductible. The good news is the

$100 is taken off your $1,000 de-
ductible leaving you only $900,

left on your deductible.
Another example is let’s say
you fall and break your leg.
The bill is $2500. You pay $900

which is what is left on your de-
ductible to reach your $1000 and

the remainder of the bill is paid
by the insurance company.
However, this doesn’t mean
your health insurance will pay
the entire bill because you still

may owe a copayment or coin-
surance. .

What is Copayment?
A copayment is a set fixed
amount you pay each time you
get a specific type of health care

Let me give you an exam-
ple. Let’s say your policy re-
quires $50 copayment each time

you see a specialist. At the time
of your service you would pay
$50. Your only responsibility is
the $50 because copayment is a

set fixed amount and not a per-
centage of the bill. Copayment is

contracted price that will never
change in the year of the policy.
In the world of Medicare +
Healthcare there are a lot of word
that might confused you so if you
have any questions or need help
please contact Jay Dorso at 860
978 1261, email Jdorso@aol.
com or go to my website www.



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