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You Need Medical Care, and You can’t Afford Your Copay


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what happens if you cant pay your copay

Do you need to visit a doctor? Don’t postpone your visit if you have medical issues. The situation may get worse if you wait. Are you worried about what you will have to pay out of your pocket? You are thin with your budget, and you can’t afford additional expenses. We get it.

There are a lot of people in the US that will postpone going to the doctor in order to avoid paying their copay. But the medical bills pile up over time, and it is not a rare situation that the medical issue will get even worse, and they need to go to the emergency room in a life-threatening situation.

What is a Copay?

There are different things that you have to pay out of your pocket if you need medical care.

To keep your insurance premiums lower, you usually have a deductible on your insurance policy. A deductible is a sum that you will have to pay by yourself before the insurance kicks in. If you, for example, have a deductible of $500 and the medical bill is $1000, you will pay $500, and the rest will pay the insurance provider.

What is a copay? A copay is usually a fixed price that you have to pay to visit a doctor. This amount usually depends on where you go. $30 copay for a primary care doctor visit or even $50 for a specialist.

What is coinsurance? Coinsurance is a percentage of the costs of covered healthcare services and is a part of a service that you have to pay. Your health plan covers the rest after paying your deductible.

Who Doesn’t Have to Pay the Copay?

Not all individuals have to pay the copay. There are some individuals that are exempted from paying:

  • Individuals that are not of legal age (younger than 18).
  • Residents in a long-term care facility or other medical institution.
  • Pregnant woman.
  • People were receiving hospice care.
  • Women in the Breast and Cervical Cancer Prevention and Treatment (BCCPT) Program.
  • People in the Title IV-B Foster Care and IV-E Foster Care and Adoption Assistance Programs, regardless of age.

How Much Do You Have to Pay for Copay?

Depending on the state where you live, there are different amounts that you will have to cover with a copay. Some average amounts are the following:

  • Primary health care ranges from $15 to $25.
  • Visiting a specialist will cost you from $30 to $50.
  • Urgent care ranges from $75 to $100.
  • Treatment in the emergency room has a copay ranging from $200 to $300.
  • A copay for prescription drugs depends on the medication.

It is worth mentioning that the copay costs less than coinsurance as it is a fixed amount that you have to pay.

What Should You Do if You Can’t Afford to Pay the Copay?

If you don’t have money and you or someone close to you need medical care, there are some options that you should consider:

Emergency Savings – If you have emergency savings, you should consider using them. Postponing the visit to a doctor wouldn’t do you any good.

  • Credit cards – Maybe you can charge the copay on your credit card and cover the money later when you have your income.
  • Borrowing some money – You can always borrow some money from your friends and family and return them later.
  • Getting a loan – If you can not afford to pay your copay, you should consider getting a loan. It will help you to get through the needed medical care, and you can repay it later.

Medical Debt

There are a lot of people that often feel ashamed of their medical debt or see it as a personal failure. Our health should be our primary issue. As most people say, you can earn money, but it is very difficult to restore your health. Our health and the health of our family should be the number 1 consideration.

The most common reason for having medical debt is a lack of insurance. If you are unable to obtain insurance through your workplace, try to find affordable medical insurance and get covered. Some of the people that are self-employed are unable to pay steep premiums for insurance. When they need medical care, the debt is just piling up.

Unpaid bills can also hurt your credit score and financial security. As a last resort for unpaid medical bills, people also file for bankruptcy.

It is a key point to budget your savings for emergency cases and to try to get good medical insurance.


Medical issues are part of our life. We should attend them as soon as possible. If you can’t afford to pay your copay, we mention a few options that you should consider. Hopefully, they were helpful.

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Frank is a graduate of the Master's program in Economics Sciences. He has been passionate about writing in the financial niche. He enjoys discovering new ways to improve personal wealth and sharing them with his readers. In addition, Frank likes to travel and play board games.

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