Copay
Also called: co-payment
Clinical reviewer: Elena Gizzi, MSN, RN · Last checked September 16, 2026
What is a copay?
Copay is a fixed dollar amount, such as $20, that you pay for a covered service or prescription after you've met your deductible. It differs from coinsurance, which is a percentage rather than a set amount. Before the deductible is met, you pay the plan's full allowed amount instead.
How is a copay different from coinsurance?
A copay is a set dollar amount, like the $20 example HealthCare.gov uses for an office visit, while coinsurance is a percentage of the allowed cost [1]. Both usually apply only after you've met your deductible; before that, you pay the plan's full allowed amount for the service [1][2].
When does a copay apply to a GLP-1 prescription?
Once a GLP-1 is covered, the copay depends on the tier the plan's drug list assigns it. Cigna's standard drug list, for example, puts generics in the lowest cost-share tier, preferred brands in the middle tier and non-preferred brands in the highest [3]. HealthCare.gov's copayment example assumes the deductible is already met [1]. The actual amount is set by your plan, so check your plan documents rather than assume a number.
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This entry is for education and is not medical advice. Talk with a licensed clinician about your own situation before starting, stopping, or changing any treatment.
