A co-payment is the portion of the bill you are responsible for. Under original Medicare you are responsible for 20% of the Medicare Approved amount. You will receive an explanation of benefits from Medicare outlining what the charges were, what was approved, what they paid and what you are responsible for. Your doctor cannot balance bill you the difference. Some states allow 15% over the Medicare approved amount in excess charges.
Medicare copayment and coinsurance are used interchangeably but they are not really the same thing. Coinsurance is traditionally used to describe your percentage share after Medicare pays their portion.
A copayment is usually a fixed dollar amount, such as the daily hospital copay once your hospital stay has exceeded 60 days.
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A copayment is usually a fixed dollar amount, such as the daily hospital copay once your hospital stay has exceeded 60 days.