What is a dental insurance copay?

What is a dental insurance copay


Copayments, also known as copays, are a common feature in dental insurance plans. But what actually is a copay? Let’s unpack the details.

What is a Copayment?

A copay, or copayment, is a preset amount you are required to pay before receiving a service or treatment covered by your insurance provider.

An example of a copayment is if you were to purchase a dental insurance plan that comes with a copay of $15 for a teeth cleaning. In this case, when you make your appointment for a cleaning and exam, you can expect to pay your dentist $15 when you check in. The next time you see that dentist for a filling, you also need to pay a $15 copy when you check in.

Copays are a single, predetermined amount that you pay before each treatment.



Copay vs. Coinsurance

Now let’s discuss the difference between copays and coinsurance. Coinsurance is a percentage of the cost that you’re responsible for paying towards the cost of a dental treatment.

Coinsurance is different from a copayment. Coinsurance is about the percentage of cost sharing between you and your insurance carrier. Coinsurance levels can vary depends upon the specific treatment you get.

If your plan says that your filling comes with 50% coinsurance, that means the plan pays 50% of the cost to the dentist, and you pay the other 50%, after applying any deductible or copay.

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Copay vs. Deductible

The deductible is the dollar amount you have to pay directly to your dentist before your benefits will begin. Your copay is the amount you pay to the dentist each time you visit for care.

Copays and deductibles on the same procedures usually don’t apply on the same plan. When they do, the copay usually does not apply to the deductible. For example, our Basic Plan has a copay of $15 for office visits, but no deductible. Our other plans with deductibles do not have any copay responsibility.

We work hard to make dental benefits as easy as possible. See for yourself how our plans can help you and your family reach your healthiest smiles.