What is the primary difference between a co-pay and a deductible?

What is the primary difference between a co-pay and a deductible?

• A. A co-pay is a fixed payment at the time of service; a deductible is paid before coverage begins
• B. A co-pay is paid once a year; a deductible is paid for each visit
• C. A co-pay is a bimonthly fee; a deductible is based on household income
• D. A co-pay is only for specialists; a deductible is for primary care services

Answer: (A)

The primary difference between a co-pay and a deductible is that a co-pay is a fixed payment made by the patient at the time of service, while a deductible is the amount that a patient must pay out-of-pocket for healthcare services before their insurance coverage begins to pay for eligible expenses. In practice, a co-pay is typically required for visits to doctors, urgent care, or emergency rooms and is set at the time of the visit. It provides a clear and predictable cost for patients upfront. On the other hand, the deductible is an annual figure that patients need to meet before their insurance covers a larger portion of their medical expenses. This means that once the deductible is met, insurance will start contributing toward costs, often covering services like hospital stays or surgeries. Other options do not accurately reflect the definitions and functions of co-pays and deductibles, making them less useful in understanding this aspect of health insurance.

The primary difference between a co-pay and a deductible is that a co-pay is a fixed payment made by the patient at the time of service, while a deductible is the amount that a patient must pay out-of-pocket for healthcare services before their insurance coverage begins to pay for eligible expenses.

In practice, a co-pay is typically required for visits to doctors, urgent care, or emergency rooms and is set at the time of the visit. It provides a clear and predictable cost for patients upfront. On the other hand, the deductible is an annual figure that patients need to meet before their insurance covers a larger portion of their medical expenses. This means that once the deductible is met, insurance will start contributing toward costs, often covering services like hospital stays or surgeries.

Other options do not accurately reflect the definitions and functions of co-pays and deductibles, making them less useful in understanding this aspect of health insurance.