See also:
Patient-Centered Formularies
Co-Payments
Defined
A co-payment is a fixed fee an insured person is expected to pay each time a particular covered medical service is received and can differ by the place of service.
Practice Setting
The Academy supports the application of differential co-payments by practice setting only to incentivize patients to select/maintain a personal medical home as defined by the AAFP. (See AAFP policy defining "Personal Medical Home")
Multiple Co-Payments
Multiple co-payments may be assessed for separately identified and delivered services. However, patients should not be required to pay more than a single co-payment for a preventive and an acute service provided during a single office visit.
Waivers
When a co-payment is a barrier to medically necessary care, physicians may on a case-by-case basis forgive or waive the co-payment. Reasons for such may include for financial hardship. Physicians should ensure that forgiving or waiving co-payments is consistent with the terms of their agreements with insurers and any applicable law.
(Board Chair October 2006)
(Board Chair October 2006)
