The copayment is the amount that has to be paid in some policies to enjoy a medical service. We tell you what it means, its characteristics, how it is applied, and its limits.
What is the copay?
The copayment is a term that refers to the amount of money that the user has to pay each time he uses a medical service, whose amount ranges from €1 to €100 depending on the type of health care, which is added to the monthly insurance premium.
At the time of taking out private health insurance, another recurring question is what it means then that it is without co-payment. Medical insurance without copay implies that no extra amount will be paid to the price paid each month for the policy.
Copay Goals
Medical insurers include copayments with a double objective: that the client makes adequate and proportionate use of health care and at the same time has an alternative to obtain a cheaper medical policy.
How and to what is the healthcare copayment applied?
The amount is charged to the bank account included in the policy on a monthly basis in most cases, although there are some insurers that allow quarterly and even annual direct debits.
Logically, the price of medical insurance with a copay is lower than one without a copay, just as not all health services include the same copay. The cost of these depends firstly on the company and secondly on the medical specialty or consultation.
In this sense, what some insurers do is include policies with a low, intermediate, or high copay, distributed according to the needs of the user. The total annual copayment limit for health insurance of this type usually ranges between €250-600, depending on the insurer. From that figure, the company will bear the costs.
Copayment of the main services and medical specialties
- General Medicine: From €2 to €20, depending on the modality
- Emergencies: from approximately €4 to €20, depending on the modality
- Hospitalization: from approximately €4 to €100, depending on the modality and the days of stay in the hospital
- Psychotherapy: approximately €10 to €16/session, depending on the modality
Differences with the pharmaceutical copay
The copayment in health insurance has little or nothing to do with the pharmaceutical copayment that has generated so much public opinion after its implementation in Spain in 2012.
Differences between the copayment in health insurance and the pharmaceutical copayment
Amount when buying a medicine or medical product with a prescription issued by the Social Security Health System
Is it mandatory to pay it?
No, the user has the option of taking out medical insurance with or without co-payment
Yes, if the user wants to have that medicine
Medical insurance with a copay or without copay?
Health copayment has its advantages and disadvantages, but all of them are linked to the requirements and, even more so, to the state of health of the insured.
Advantages
- The cost is much lower than the price of a medical consultation without having contracted a medical policy so that in some way cheap health insurance is obtained.
- The premium is lower if you are in good health
- Improvement in health services. Although this advantage is more subjective, the fact of having to pay for medical consultations means that they are used properly.
Disadvantages
- The premium for co-pay insurance can increase from year to year depending on the policy adopted by the insurer.
- Worsening of the disease: in the case of families going through an economic downturn, with children or adults in their care, it may be that they do not go to the consultation, and some symptoms that are not very important at first end up getting complicated.
At the time of opting for one option or another, it is advisable to focus on both the economic and health aspects. With this clear idea, it is advisable to go to a health insurance comparator to see which is the best health insurance that may interest you.
