What Is the Copayment for Medicare?


Quick Answer

The copayment for Medicare is a fixed amount that a patient pays for each prescription, outpatient hospital visit or doctor's appointment after paying any deductible, explains Medicare. Medicare bases copayment levels, called tiers, on categories of services or supplies. For instance, name-brand medications may have higher copayments than generic ones.

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Full Answer

As of 2015, a copayment is a preset amount, unlike coinsurance, which is a percentage-based cost. For example, a Medicare patient with a $10 copayment pays $10 whether the cost of the service or supply item is $40 or $60. However, a patient with a 25 percent coinsurance rate pays $10 for a $40 service or supply item and $15 for a $60 service or supply item, according to Medicare.

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