copay

[koh-pey]

noun

1. a small fixed amount required by a health insurer to be paid by the insured for each outpatient visit or drug prescription.

Word History and Origins

Origin of copay¹

1970–75

Example Sentences

Eli Lilly and Novo Nordisk will make their GLP-1 drugs available under Medicare for about $245 a month, with patients paying a $50 copay starting as early as April 2026.

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Taylor Langlois, an insurance broker in Wichita, Kan., has a client in a rural area who recently suffered a fall and experienced the kind of medical emergency that could result in several copay charges.

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Typically, under the previous system, a customer’s copay was based on a high list price set by the drug company, while pharmacy benefit managers like Evernorth negotiated a rebate that was paid back after.

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If an employer offered a GLP-1 with a $0 monthly copay and restricted coverage to diabetic and obese plan participants, premiums for everyone in the plan would increase approximately 6% the next year, said Jake Spiegel, a senior research associate at EBRI.

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Even after introducing a $90 monthly copay — a typical price for a specialty medication, Spiegel noted — GLP-1 prescription coverage for overweight users would still result in an approximate 9% increase in premiums.

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