What are fixed and variable copays in an insurance system?
These will depend on the plan or the premium to be paid by the insured. In addition, they will vary according to the product or service that the patient requests at the medical institution.
In insurance systems, copayment is a main factor within the insured’s contract, which can be fixed or variable. It is a kind of tax that the person cancels, within their insurance, as part of the cost of the health care they require.
Variable copayment
The fixed or variable copayment will depend on the contract and income that the patient has, in addition to the possibilities of the health entity. For example, when a user requires a drug for treatment in a private medical center, part of the price will be paid by the insurance, while the remainder will be the copayment that the user will need to pay. Thus, it then makes it possible to reduce healthcare costs and makes the patient aware of responsible costs.
Fixed copayment.
It is, in general, a fixed amount that the user must cancel (and of which he is informed in the plan and contract of his insurance) before the insurance itself covers the final expenses. The cost may vary depending on the consultation, the specialty in the medical center, the type of medicine, among other factors, but it is always specified in the plan.
For example, a fixed copayment may be a single payment of 20 soles for medical consultation in a private clinic. Also, the higher the insurance premium to pay, the lower the fixed copayments (and vice versa).
Variable copayment.
It is usually represented as a percentage of the cost that the company needs to pay. For example, some plans mention coverage of 80% of the payment by the insurer in medicines. While the patient is responsible for the rest. Thus, the final amount may vary depending on what you want to purchase. Be it a medical consultation, a product, treatment, etc.
Both types of copay are seen in most insurance plans. As mentioned, One of the objectives of this variable is to create awareness in people about the responsible use of medical services. All companies, in their objective of identifying how to properly care for a patient.
When does the deductible apply?
Most health insurance plans have a deductible that must be met before the coinsurance split begins. That means you will pay 100 percent of the plan’s negotiated cost for your medical treatment until you meet your deductible, and then the coinsurance split will apply until you meet your out-of-pocket maximum for the year.
Example
If your plan has a deductible of $ 1,000 and then coinsurance of 80/20. You will pay the first $ 1,000 for services that apply to the deductible (which generally does not include any services for which a copay applies). And then begin to Pay 20 percent of your subsequent costs. And the insurance company will pay 80 percent. This will continue until you reach your out-of-pocket maximum. When this happens. The insurance company will begin to pay 100 percent of your covered costs for the remainder of the year.
