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Copay, coinsurance and out-of-pocket maximum

Using your insurance plan may be easier when you understand common health care terms and what they mean. It also may make it easier to manage your health care costs when you learn what the cost terms mean for your wallet. So, let’s take a closer look and learn the difference between copays, coinsurance and out-of-pocket maximums.

What is a copay?

A copay (or copayment) is a fixed amount you may pay for a covered health care service, usually at the time you receive the service

How does a copay work?

You might remember times when you went in for a doctor visit and maybe paid a $15 or $20 copay before or after your visit. Copay amounts can vary depending on the provider and service. With health plans that have copays (not all do), you’ll know exactly what you have to pay ahead of time – which can help you budget your health care costs. For most plans, your copay does not apply toward your deductible. Also, some services may be covered at no additional cost, or $0 cost share, such as annual wellness exams and certain other preventive care services.

What is copay?

Video transcript

It’s a fixed amount you pay for health care services.

A copay is often paid right at the doctor’s office.

For example, a copay may be $15, $25 or another amount.

The amount can vary by the type of covered health care service.

Copays made clear

What is coinsurance?

Coinsurance is a percentage of the cost of a covered service. Until you reach your deductible, you’ll pay for 100% of out-of-pocket costs. After you meet your deductible, you and your insurance company each pay a share of the costs that add up to 100 percent. Typical coinsurance ranges from 20% to 40% for the member, with your health plan paying the rest. But cost-sharing percentages will vary depending on your plan.

How does coinsurance work?

If your doctor visit costs $100 and you’ve met your deductible, your coinsurance payment of 20% would be $20 out of pocket. Your insurance would then pay the rest of the allowed amount ($80). Keep in mind, your coinsurance benefit doesn’t apply until after you’ve reached your deductible. Until then, you’ll need to pay 100% of the cost.

ON-SCREEN TEXT:

It’s your share, or % you pay, of the cost for covered services after you meet your deductible.

For example, if your office visit is $100 and your coinsurance is 20%, then you would pay $20.

Your health insurance plan would pay the other 80%.

Coinsurance made clear

What is an out-of-pocket maximum or limit?

You might have heard terms like out-of-pocket maximum or limit. But good news — they actually mean the same thing. So your out-of-pocket maximum or limit is the highest amount of money you could pay during a 12-month coverage period for your share of the costs of covered services. Typically, copays, deductible, and coinsurance all count toward your out-of-pocket maximum. Keep in mind that things like your monthly premium, balance-billed charges or anything your plan doesn’t cover (like out-of-network costs) do not.

When a provider bills you for the difference between the provider’s charge and the allowed amount. For example, if the provider’s charge is $100 and the allowed amount is $70, the provider may bill you for the remaining $30. A preferred provider may not balance bill you for covered services.

How does an out-of-pocket maximum work?

If you meet your out-of-pocket maximum, your plan will usually pay 100% of your covered health care costs (up to the allowed amount ). Let’s say you have an annual out-of-pocket maximum of $6,000. That means once you’ve paid $6,000 out of pocket that year for your covered health care, usually including deductibles, copays and coinsurance, your plan will cover any future (covered, in-network) health care services during your coverage period.

The maximum amount a plan will pay for a covered health care service. May also be called “eligible expense,” “payment allowance,” or “negotiated rate.” If your provider charges more than the plan's allowed amount, you may have to pay the difference (balance-billed charge).

What is out of pocket limit?

What is an out-of-pocket limit?

It’s the maximum amount you could pay for covered services in a plan year.

After you meet your out-of-pocket limit, your health plan usually pays for 100% of the rest of your covered

services for the rest of the year.

That helps you plan ahead for health care costs.

Out-of-pocket limits made clear

Compare how copays and coinsurance work

There's a lot to understand when you're sorting out the difference between copays and coinsurance. Here's a quick view to help explain how these two types of payments work differently. 

Knowing how copays, coinsurance and out-of-pocket maximums work can help you add up your potential costs more accurately when you're planning for the year or when you're choosing your health plan during open enrollment . 

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What is a ‘copay’?

Healthcare is a complex subject with terms that can seem like a completely different language at times. One of those terms is copayment , or better known as copay . A copay is a fixed amount paid for prescriptions or healthcare services when you visit the doctor. But like most things health insurance-related, is it really that simple?

What is a copay?

For most insurance plans, every time you see a doctor after meeting your deductible you pay a set amount called a copay. A copay works as a flat-fee your general practitioner or specialist charges you for using their services. The specific amount is determined by your health insurance plan, so make sure to read the fine print. Plans with lower monthly premiums may have higher copays.

It’s important to note that copays are for commercial, employer, and marketplace insurance. Medicare and Medicaid will have different rules and recommendations than the following information.

Copays are a form of cost sharing with your health insurance company. They also are intended to help deter consumers from accessing unneeded medical care. Copays can have some complicated relationships with other parts of your health insurance cost structures.

Before you reach your annual deductible —which is the amount of money you have to pay before your insurance company will help cover your medical expenses—you will foot the entire bill for a covered procedure or prescription. Once you’ve reached your deductible, your coinsurance kicks in, meaning your plan will start being responsible for a set percentage of medical costs. This is where your medical expenses get tricky, especially since your copay does not count toward your deductible, but rather goes toward your annual out-of-pocket maximum . 

Now, here’s an example to help clear things up: You sprained your foot playing soccer and think, “Boy, I’m so lucky I recently met my deductible, and insurance will cover this trip to urgent care.” But what you don’t realize is you’re responsible for your copay and coinsurance. Before you leave the doctor’s office, the receptionist asks you to pay your $20 copay upfront. Two weeks later, you receive a bill for an additional $80—this is your coinsurance, which in this example is 20% of any medical bill total (and in your case it was a $400 bill). Thus, for this sprained foot, you ended up paying $100. Plans often negotiate rates, so they will pay your provider a percentage of the negotiated rate before you’re expected to pay your appropriate coinsurance amount. 

People tend to think that once they reach their deductible, they’ll be free of medical bills. However, insurance will only cover all your medical expenses once you’ve met your out-of-pocket maximum, which is met by a combination of paying your deductible, coinsurance, and copays.

RELATED: What’s the difference between a copay vs. deductible?

What does a copay cover?

A copay usually helps cover costs at a variety of office visits. However, medical services requiring copays vary between insurance plans. Services that typically require a copay include:

• Primary care and specialist doctor visits
• Physical, occupational, and speech therapies
• Prescription drugs
• Mental health services: i.e. drug rehabilitation, psychotherapy 
• Urgent care
• Emergency room visits
• Ambulance rides

Copay prices typically vary between services and could be higher at a specialist visit than a primary care physician visit. Out-of-network providers will also usually have a higher copay. If your copay is high cost across the board, this may be because you have a lower-premium health insurance plan. 

It is also important to note that due to the Affordable Care Act , some preventive care services such as checkups, cancer screenings, or a well-woman visit should have no consumer cost-sharing.

How do I know if I will have a copay?

Most insurance companies or healthcare providers require copays to be paid at the time of service. Oftentimes, the copay amount is printed directly on your health insurance card. It may even have the amounts listed for different services like a primary care visit and specialist care services. Look at your insurance plan to get a detailed list of all covered services requiring a copay and the cost of each.

Some insurance plans have no copay. In this case, it is probably a more expensive plan, so while there is no copay for services, you are still spending extra money with the plan premiums. 

How to lower your copay

Out-of-pocket costs don’t always have to hit your bank account. If you contribute to a health savings account (HSA), flexible savings account (FSA), or health reimbursement account (HRA),  you can use these pre-tax funds to cover your copay. After all, this is money you’ve already set aside for health benefits. However, the only way to lower your copay would be by switching insurance plans, which isn’t always an option.

However, SingleCare is here to help . Sometimes copays for prescriptions could be higher than the discounted rate you could get with a SingleCare card. Search for your prescription at singlecare.com to see what your best price is.

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Understanding Copays, Coinsurance and Deductibles

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Coinsurance, copays and deductibles are different out-of-pocket costs for health care, and being familiar with these terms can help you better understand your health coverage and costs. Even after you pay monthly premiums for health insurance , out-of-pocket costs can lead to high medical bills if you get sick or injured.

Here's how health insurance costs work.

Defining some health insurance terms

Before understanding how it all works together, let's brush up on some common health insurance terms.

Coinsurance

Coinsurance is a percentage of a medical charge you pay, with the rest paid by your health insurance plan, which typically applies after your deductible has been met. For example, if you have 20% coinsurance, you pay 20% of each medical bill, and your health insurance will cover 80%.

A copay, or copayment , is a predetermined rate you pay for health care services at the time of care. For example, you may have a $25 copay every time you see your primary care physician, a $10 copay for each monthly medication and a $250 copay for an emergency room visit.

The deductible is how much you pay before your health insurance starts to cover a larger portion of your bills. In general, if you have a $1,000 deductible, you must pay $1,000 for your care out of pocket before your insurer starts covering a higher portion of costs. The deductible resets yearly.

The premium is the monthly payment you make to have health insurance.

You pay the premium each month like a gym membership, even if you don't use the coverage. If you don't pay the premium, you may lose your insurance. If you're fortunate enough to have employer-provided insurance, the company typically picks up part of the premium.

Out-of-pocket maximum

The out-of-pocket maximum is the limit of what you'll pay in one year, out of pocket, for your covered health care before your insurance covers 100% of the bill. The maximum out-of-pocket limit for marketplace health plans (those on the Affordable Care Act health insurance marketplace) is $9,450 for an individual and $18,900 for a family in 2024 . (This amount doesn't include what you spend for services your insurance doesn't cover.)

Coinsurance vs. copay

Copays and coinsurance are different ways your health insurance may require you to pay for covered services. Here are the differences:

Copay vs. deductible

Your health plan may have both copays and deductibles, and whether you pay one or the other may depend on the services you receive. For some services, such as a visit to your primary care doctor, you may owe a fixed copay, such as $10 or $20. For other services, such as an MRI, you may have to pay the approved cost of the service up to your deductible.

Your copay may count toward your deductible, but it doesn't always. And you may owe copays for some services after you meet your deductible.

Coinsurance vs. deductible

Deductibles and coinsurance work together, but usually consecutively. As mentioned, the deductible is the amount you pay before your insurance starts covering the cost of your health care. Once you meet your deductible, you'll typically owe coinsurance (such as 20% of approved charges) on all additional services for the rest of the year.

You'll pay coinsurance on approved medical care until you hit the out-of-pocket maximum on your plan, after which your insurance will cover 100% of the rest of your care for the year.

How it all works together

Health insurance policies can have a variety of cost-sharing options. For example, some policies have low premiums, high deductibles and high maximum out-of-pocket limits, while others have high premiums, lower deductibles and lower max out-of-pocket limits.

In general, it works like this: You pay a monthly premium to have health insurance. Then, when you go to the doctor or the hospital, you pay either full cost for the services or copays as outlined in your policy. Once the total amount you pay for services, not including copays, adds up to your deductible amount in a year, your insurer starts paying a more significant chunk of your medical bills, commonly 80%. The remaining percentage that you pay is called coinsurance.

You'll continue to pay copays or coinsurance until you've reached the out-of-pocket maximum for your policy. At that time, your insurer will start paying 100% of your medical bills until the policy year ends or you switch insurance plans.

The catch: Your health plan's network

Here's the snag: The co-sharing scenario highlighted above works only if you choose doctors, clinics and hospitals within your health plan's provider network. If you use an out-of-network doctor, you could be on the hook for the whole bill, depending on which type of policy you have. This brings us to two related terms:

This is the group of doctors and providers who agree to accept your health insurance. Health insurers negotiate lower rates for care with the doctors, hospitals and clinics in their networks. So when you go in-network, your bills will typically be cheaper, and the costs will count toward your deductible and out-of-pocket maximum.

Out of network

A provider your insurance plan hasn't negotiated a discounted rate with is considered out of network. If you get care from an out-of-network provider, you may have to pay the entire bill yourself, or just a portion, as indicated in your insurance policy summary.

» MORE: What the No Surprises Act means for your medical bills

Doing the math on copays, coinsurance and deductibles

To illustrate with an example, consider a person — let's call her Prudence — who needs some health services. (Your costs would be different based on your policy, so you'll want to do your own calculations.)

Prudence's policy:

Insurance coverage: Single.

Annual deductible: $1,200.

Copays: $20 per office visit, $50 per specialist, $100 per ER visit; these don't count toward her deductible.

Coinsurance: 20% after she meets her deductible.

Scenario: Doctor visits and an MRI

Prudence goes in for an annual checkup. Because she goes to an in-network provider, this is a free preventive care visit. (If it had been an office visit for a medical issue, there would have been a $20 copay.) However, her primary care physician thinks Prudence should see an orthopedist based on her physical exam. The orthopedist later recommends an MRI.

Copays for an in-network specialist on her plan are $50. The MRI provider is in her insurer's network, and the approved insurance charge is $1,000 for the MRI, including the radiologist fees for interpreting the scan.

Imaging scans like this are "subject to deductible" under Prudence's policy, so she must pay for it herself, or out of pocket, because she hasn't met her deductible yet.

Total out-of-pocket costs: $50 for the specialist copay + $1,000 for the scan = $1,050.

Scenario: Trip to the ER

Later that year, Prudence falls while hiking and hurts her wrist. She heads to an in-network emergency room, for which she has a $100 copay. After the copay, ER charges are $3,400. Her deductible will be applied next.

Prudence has already paid $1,000 of her $1,200 deductible for her MRI, so she's responsible for $200 of the ER bill before her insurer pays a larger share. Of the remaining $3,200, her health plan will pay 80%, leaving Prudence with a 20% coinsurance of $640.

Total out-of-pocket costs: $100 for the ER copay + $200 for remaining deductible + 20% coinsurance ($640) = $940.

Prudence has now paid $1,990 toward her medical costs this year, not including premiums. She has also met her annual deductible, so if she needs care again, she'll pay only copays and 20% of her medical bills (coinsurance) until she reaches the out-of-pocket maximum on her plan.

Understanding how your health insurance works can save you money and grief now and down the road.

On a similar note...

What Is A Copay?

Key takeaways.

A copay A copayment is the fixed amount you pay directly to your provider for medical services or prescription drugs covered in your plan. For example: If your plan includes a copayment of $20 for office visits, you'll pay $20 to your doctor whenever you have an appointment. is a flat fee you’re required to pay at the time of receiving medical service or care.

The amount of your copay depends on if it’s a visit for a doctor,  specialist, or even emergency care. Copays for doctor visits are generally lower compared to specialist or urgent care visits.

What is a Copay?

A copay, or copayment, is a fixed dollar amount you pay every time you go to the doctor or fill a prescription. It’s a shared cost between you and your insurance company. You pay the copayment, and your insurer pays the rest of the bill typically.

Find a local Medicare plan that fits your needs.

How Does a Copay Work?

Your insurance company sets a fixed copay amount for the respective service. After you reach your annual out-of-pocket maximum , you will no longer have to pay copays.

Here’s an example on how copays works:

• Total cost: $100
• Insurance pays: $80
• Your copay: $20

The rate usually stays the same regardless of how many times you see your doctor. However, the cost can vary based on different services, such as lab tests, seeing specialists, or urgent care visits. The copay amount can also change based on the brand name or generic medications. 

While health insurance plans vary depending on the coverage level, policies with higher monthly premiums A premium is a fee you pay to your insurance company for health plan coverage. This is usually a monthly cost. generally have lower copays. Plans with lower premiums tend to have higher copays. If you frequently go to the doctor’s office, consider selecting a plan with a lower copay for visits.

What’s the Difference Between Copays and Coinsurance?

Copays and coinsurance are two different costs shared with your insurance company. Coinsurance is a percentage of a total medical bill split between you and your insurer. For example, your insurance plan may cover 80% of the cost, while you’re responsible for the remaining 20%. Coinsurance usually begins after you have met your deductible, whereas copays generally must be paid at the time you receive care.

Here’s an example of how they work with your plan:

A copay is a flat rate you will pay for a visit to the doctor. For example, a primary care visit may cost $180, but you only pay your copay amount for the visit. That means if your copay for a primary care visit is $20, you pay $20 instead of the $180.

Coinsurance is a cost percentage split between you and your insurance company after you meet your deductible. For example, if your deductible is $1,000, you pay 100% of costs until you reach $1,000. After you reach $1,000, you may only be responsible for 20% of your cost if your plan has an 80/20 coinsurance. This means, after your deductible, you pay 20% and insurance pays 80%.

Let’s see how it works together. If you have a $20 copay and 80/20 coinsurance, for a doctor visit that costs $180:

• Your copay would be $20
• Your coinsurance would be $180 before your deductible is met, and $36 after your deductible is met.

Let’s find your ideal Medicare Advantage plan.

How much are my copays if I have a Health Insurance Marketplace plan?

Your copay is determined based on your level of health insurance coverage. Marketplace policies fall into different categories (gold, silver, bronze, and platinum), also called metal tiers. The types do not represent the quality of care, just the level of coverage. [i]

• Monthly premium: Highest
• Copays: Lowest
• Monthly premium: Higher
• Copays: Lower
• Monthly premium: Moderate
• Copays: Moderate
• Monthly premium: Lower
• Copays: Higher

Your copay amount is usually found on your insurance card.

Do my copays count toward my deductible?

It depends. Some health plans allow copays to go towards a deductible and others do not.  A deductible  is an amount you pay out-of-pocket before your health insurance starts to pay for medical services.

The ‘metal’ categories: Bronze, Silver, Gold & Platinum TRUSTED & VERIFIED healthcare.gov . HealthCare.gov.

This website is operated by GoHealth, LLC., a licensed health insurance company. The website and its contents are for informational and educational purposes; helping people understand Medicare in a simple way. The purpose of this website is the solicitation of insurance. Contact will be made by a licensed insurance agent/producer or insurance company. Medicare Supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. Our mission is to help every American get better health insurance and save money. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.

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The maximum amount a plan will pay for a covered health care service. May also be called “eligible expense,” “payment allowance,” or “negotiated rate.”

Refer to glossary for more details.

The amount you pay for covered health care services before your insurance plan starts to pay. With a $2,000 deductible, for example, you pay the first $2,000 of covered services yourself.

• If you haven't met your deductible: You pay $100, the full allowable amount for the visit.

The amount you pay for your health insurance every month. In addition to your premium, you usually have to pay other costs for your health care, including a deductible, copayments, and coinsurance. If you have a Marketplace health plan, you may be able to lower your costs with a premium tax credit.

Related content

• Learn how deductibles and copayments affect your total costs of care

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How much does urgent care cost?

• Urgent care clinics offer convenient and quick medical attention, often with shorter wait times and lower costs than emergency rooms. The cost of a visit can range from $32 to $175, depending on location, type of medical care received, and insurance coverage.
• Factors affecting the cost of urgent care include insurance coverage and the type of service needed. Urgent care is often a more affordable choice compared to other healthcare options, such as emergency rooms or primary care physicians.
• Urgent care clinics have different policies regarding payment for services. Some require payment at the time of service, while others may bill patients after the visit. If unexpected bills arise, it's advised to review the bill for accuracy and negotiate a payment plan if necessary.
• Insurance coverage for urgent care varies depending on the plan. Many popular insurance plans, including private insurance, Medicare, and Medicaid, cover urgent care visits. However, copays or coinsurance may still apply. Urgent care clinics usually accept various payment methods, including insurance, credit cards, and cash.
• Some urgent care clinics offer payment plans to help patients manage healthcare costs over time. These plans allow patients to spread out the cost of treatment, making it more affordable. However, the availability and terms of these plans can vary, and it's important to consider the pros and cons before opting for a payment plan.

How Much Does It Cost to Visit Urgent Care?

Can urgent care bill you later, how much is urgent care with insurance, can you pay cash at urgent care, does urgent care do payment plans, urgent care costs with medicaid, when to go to urgent care, is urgent care cheaper than er, going to urgent care.

• Frequently Asked Questions

As a parent, you know that unexpected illnesses and injuries can happen at any time—and the cost of urgent care visits can quickly add up. We’re here to offer some helpful insights on the costs associated with urgent care, and understanding how insurance and self—pay options work with urgent care.

First, let’s define what an urgent care clinic is. Urgent care clinics are designed to offer convenient and quick medical attention. Often they are known for shorter wait times and lower costs than visiting an emergency room.

The cost of urgent care varies depending on the location and the type of medical care that you receive. Additionally, your insurance coverage may also affect your cost.

On average, the cost of a visit to an urgent care center can range from $32 to $175, according to research conducted by Forbes in 2023. It's important to note that these costs are often less expensive than a visit to an emergency room, as noted by Debt.org. However, these costs may not include the cost of any diagnostic tests or follow-up care that may be needed.

Factors That Affect the Cost of Urgent Care

As mentioned, there are some factors that can affect the cost of your visit to urgent care. One of the biggest factors, according to Forbes, is whether or not you have insurance. If you do have insurance, your out-of-pocket costs will likely be lower. However, if you don't have insurance, you may be responsible for the full cost of your visit.

Another factor that can affect the cost of urgent care is the type of service you need. For example, an visit for an immunization may be less expensive than a more complex procedure or testing.

Comparison of Urgent Care Costs to Other Healthcare Options

Compared to other healthcare options, such as visiting the emergency room or seeing your primary care physician, urgent care is often a more affordable choice. According to Debt.org, an emergency room visit is around 10 times more expensive than visiting an urgent care clinic.

According to United Healthcare, the average cost of an in-person visit to a primary care provider is around $170, however, most primary care offices are only open during traditional business hours and may not have the ability to run diagnostic tests such as x-rays and lab services, which are available in many urgent care clinics.

Every urgent care clinic has its own policy regarding payment for services. Some urgent care clinics require payment at the time of service. This means that you will be asked to pay your copay or deductible before you leave the clinic. If you do not have insurance, you may be required to pay the full amount of the visit before you leave.

Some urgent care clinics may be able to bill patients after the visit. The best way to know how your urgent care clinic handles its billing is to ask them. You can call before your appointment or look at their website for more information.

How to Handle Unexpected Bills from Urgent Care

If you receive an unexpected bill from an urgent care clinic, the first thing you should do is review the bill to ensure that it is accurate. Be sure to check the date of service, which services were provided, and the name of the patient or responsible party. Although billing mistakes are very rare, they can happen.

If you have insurance, you should contact your insurance company to determine why the claim was denied. If you do not have insurance, you may be able to negotiate a payment plan with the urgent care clinic.

It is important to note that some urgent care clinics may send bills to collections if they are not paid in a timely manner. If you receive a bill from a collection agency, you should contact the collection agency and negotiate a payment plan.

When you have insurance, the cost of urgent care can vary depending on your plan. Some insurance plans cover the full cost of urgent care visits, while others require you to pay a copay or coinsurance. Copays are a fixed amount you pay upfront for a visit, while coinsurance is a percentage of the total cost you are responsible for paying, according to United Healthcare.

Types of Insurance That Cover Urgent Care

Many popular insurance plans cover urgent care visits, including private insurance, Medicare, and Medicaid. However, it's important to check with your insurance provider to see what your specific plan covers.

How to Find Out If Your Insurance Covers Urgent Care

To find out if your insurance covers urgent care, you can check your plan documents or call your insurance provider. You can also check with the urgent care clinic you plan to visit to see if they accept your insurance. It's important to note that even if your insurance covers urgent care, you may still be responsible for paying a copay or coinsurance.

When it comes to payment options at urgent care clinics, you can expect that they accept a variety of payment methods. This includes insurance, credit cards, and cash. Some facilities may also accept personal checks, but it's always best to check with the specific urgent care facility beforehand to confirm.

If you are paying for your visit without insurance coverage, you may want to ask the clinic about their self-pay options. Some clinics offer payment plans or have a sliding scale fee based on income. Some clinics offer a ‘cash discount’ rate that may be cheaper than your high deductible health plan.

When paying out of pocket for urgent care, it's important to ask about the cost of services upfront. This can help you avoid any surprises when it comes time to pay.

Healthcare costs are a concern for many Americans. Fortunately, some urgent care clinics offer payment plans to help you pay for your medical care over time. Payment plans allow you to spread out the cost of your treatment, making it more affordable and manageable.

The payment plan options available at urgent care facilities may vary depending on the location and the provider. Some facilities may offer interest-free payment plans, while others may charge interest, according to Experian. It's important to ask about the payment plan options available before receiving treatment so that you can make an informed decision.

How to Set Up a Payment Plan at Urgent Care

To set up a payment plan with urgent care, you will need to speak with the billing department at the clinic where you received treatment. They will be able to provide you with information about any available payment plan options and help you choose the best one for your needs.

When setting up a payment plan, you may need to provide some basic information, such as your name, address, and contact information. In some cases, Experian notes that you may also need to provide information about your income and expenses to help determine your monthly payment amount.

Pros and Cons of Using a Payment Plan

Using a payment plan to pay for your urgent care bills can have both advantages and disadvantages, according to Experian. Some of the pros of using a payment plan include:

• The ability to spread out the cost of your treatment over time, making it more affordable
• The flexibility to choose a payment plan that fits your budget and financial situation
• The option to pay off your bills without accruing interest (if interest-free payment plans are available)

However, there are also some cons to using a payment plan, such as:

• The potential for interest charges to accrue (if interest is charged on the payment plan)
• The need to make monthly payments, which can be challenging if you are on a tight budget
• The possibility of damaging your credit score if you are unable to make payments on time

Overall, payment plans can be a helpful option for those who are unable to pay their medical bills at the time of treatment. However, it's important to carefully consider the pros and cons before making a decision.

Medicaid may be able to cover some or all of the cost of urgent care, but this depends on your state, according to HealthNews.com. Any costs that you pay will depend on your specific Medicaid plan, the urgent care location that you visit, and the services that you receive.

Types of Medicaid That May Cover Urgent Care

Types of Medicaid, according to Mediciad.gov, include:

• Traditional Medicaid
• Medicaid Managed Care
• Children's Health Insurance Program (CHIP)

Each type of Medicaid may cover urgent care visits, however, coverage will depend on your state. You can learn about your urgent care coverage information by contacting your case manager, looking at your coverage paperwork, or talking to the urgent care clinic.

Urgent care clinics are designed to handle non-life-threatening medical conditions. This includes minor illnesses and injuries, according to Scripps.org, some common ailments that can be treated at urgent care include:

• Sore throat, and other symptoms of cold or flu
• Symptoms of COVID-19
• Symptoms of UTI
• Symptoms of STDs
• Vomiting or diarrhea
• Fever that doesn’t go away with fever-reducing medication
• Small cuts or lacerations that may need stitches
• Simple fractures
• Allergic reactions and skin rashes
• Routine physicals (like sports physicals or DOT physicals)
• Immunizations

Urgent care clinics are generally less expensive than emergency rooms. In fact, according to Debt.org, going to an emergency room can be around 10 times more expensive than visiting an urgent care clinic.

According to United Health, the average cost of an ER visit is around $2,600, while the average cost of a visit to urgent care (including testing) is around $185.

Cost of Urgent Care vs. ER Visits

The cost of urgent care and ER visits can vary depending on several factors. Since both urgent care clinics and emergency rooms typically charge based on the services provided, it is difficult to calculate your specific costs. You may be able to call ahead to your urgent care clinic and ask what their costs are for an exam and routine testing.

Getting timely medical care is important for maintaining good health and preventing serious medical conditions. Delaying medical care can sometimes lead to complications and even death, according to the NIH.

Whether or not you have insurance, urgent care clinics are a great choice for getting high-quality healthcare at a more affordable cost.

Find urgent care clinics near you by searching Solv .

Frequently asked questions

What is an urgent care clinic, how much does a visit to an urgent care clinic typically cost, what factors can affect the cost of an urgent care visit, can urgent care clinics bill you later, how much does urgent care cost with insurance, can you pay cash at urgent care, do urgent care clinics offer payment plans, is urgent care cheaper than the emergency room.

Michael is an experienced healthcare marketer, husband and father of three. He has worked alongside healthcare leaders at Johns Hopkins, Cleveland Clinic, St. Luke's, Baylor Scott and White, HCA, and many more, and currently leads strategic growth at Solv.

Dr. Rob Rohatsch currently serves as Chief Medical Officer for Solv Health. Dr. Rohatsch brings his extensive background in multi-site ambulatory medicine operations, on-demand healthcare, and consumerism to Solv, where he helps drive strategic initiatives in a cross functional executive role. He brings comprehensive healthcare expertise ranging from medical group operations to revenue cycle management and clinical expertise. 

Dr. Rohatsch completed his military service in the US Air Force and earned his MD from Jefferson Medical College of Thomas Jefferson University. Dr. Rohatsch served on the Yale School of Medicine faculty teaching at the medical school and is currently on faculty at the Haslam School of Business at the University of Tennessee teaching in the Executive MBA Program. He also serves on several boards and chairs The TJ Lobraico Foundation.

Solv has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references.

• How Much Does an Urgent Care Visit Cost in 2023? (July 21, 2023) https://www.forbes.com/advisor/health-insurance/urgent-care-cost/
• Emergency Rooms vs. Urgent Care Centers. (July 21, 2023) https://www.debt.org/medical/emergency-room-urgent-care-costs/
• Cost of Urgent Care vs. Cost of ER Visit. (July 21, 2023) https://www.afcurgentcare.com/blog/cost-of-urgent-care-vs-cost-of-er-visit/
• United Healthcare: What Are My Care Options and Their Costs? (July 21, 2023) https://www.uhc.com/member-resources/where-to-go-for-medical-care/care-options-and-costs
• How Much Does Urgent Care Cost? (July 21, 2023) https://urgentway.com/how-much-does-the-urgent-care-cost/
• How do Medical Bill Payment Plans Work? (July 21, 2023) https://www.experian.com/blogs/ask-experian/medical-bill-payment-plans/
• Medical Debt and Collections. (July 21, 2023) https://www.experian.com/blogs/ask-experian/medical-bill-payment-plans/
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The Definitive Guide to Understanding Copays, Coinsurance, and Deductibles

Healthcare can be confusing, especially when it comes to understanding copays, coinsurance, and deductibles. What's the difference between them? How do they work together? And what does it all mean for me and my health insurance plan? In this article, we will answer all of your questions and help you understand these important concepts. So read on and learn everything you need to know about copays, coinsurance, and deductibles!

Copays, Coinsurance and Deductibles Definitions

Let's start with the definitions and look at what these terms mean, how they work together, and how they are different.

What is a Health Insurance Copayment?

A copayment, also called a copay, is a fixed amount that you pay for a healthcare service. For example, you might have a $20 copay for an office visit or $50 copay for an emergency room visit. The amount of the copayment may vary depending on the type of service you receive.

Copays are usually paid at the time of service. So, if you go to the doctor, you would pay your $20 copay at the end of your visit. Some health insurance plans require that you pay your copays upfront before receiving care.

Your health insurance plan will likely have different copays for different types of services. For example, you might have a lower copay for preventive care than you would for specialist care.

Copays do not count towards your deductible. This means that you will still be responsible for paying your deductible even if you've already paid copays for services during the year.

What is a Deductible?

A deductible is the amount of money you are required to pay out-of-pocket before your health insurance plan starts to pay for covered services. Once you reach your deductible, your health insurance plan will begin to cover a portion of the cost of covered services.

For example, let's say that your health insurance plan has a $500 deductible and you go to the doctor for a $100 office visit. You will be responsible for the entire $100 bill because you have not yet reached your deductible.

Now, let's say that you go to the doctor again six months later and this time your bill is for $600. Since you've already paid $500 towards your deductible, you will only be responsible for the remaining $100. Your health insurance plan will cover the rest.

It's important to remember that deductibles apply to most, but not all, types of services. For example, some plans may exempt preventive care from the deductible. This means that you would not have to pay your deductible before receiving preventive care services.

To learn more about health insurance deductibles and how it works, you can read our blog here .

What is Coinsurance?

Coinsurance is a type of cost sharing that requires you to pay a percentage of the cost of a covered service, rather than a fixed copayment amount.

For example, let's say that your coinsurance is 20% and you go to the doctor for a $100 office visit. You will be responsible for $20 (20% of $100) and your health insurance plan will cover the remaining $80.

Coinsurance usually applies after you've met your deductible. This means that you would first have to pay your deductible before your coinsurance would apply.

What is the Difference Between a Deductible and a Copay?

The main difference between a deductible and a copayment is that deductibles apply to all or some healthcare costs while copayments only apply to specific healthcare services.

Deductibles also have to be met before your health insurance company starts paying, while copayments are paid at the time you receive healthcare services.

What's the Difference Between Coinsurance and a Copay?

Coinsurance is a percentage of covered healthcare costs that you pay, while copays are flat fees.

Coinsurance applies after you've met your deductible, while copays may be paid before meeting your deductible.

Both coinsurance and copays are listed in the schedule of benefits or summary of benefits and coverage for your health insurance plan.

How Do Copays, Coinsurance and Deductibles Work Together?

Now that we've defined each term, let's look at how they work together.

Say you have a $500 deductible and 20% coinsurance. That means you would have to pay the first $500 of covered healthcare costs yourself, and then you would be responsible for 20% of the remaining covered costs. Your health insurance company would pay 80% of the remaining covered costs.

For example, let's say you went to the doctor for a check-up and the total cost was $100. Since that cost is below your deductible, you would be responsible for the entire amount.

Now let's say you had to go to the hospital for surgery and the total cost was $30,000. You would pay the first $500 (your deductible) and then 20% of the remaining $29,500, which would come to $5900. Your health insurance company would pay the remaining $24,600.

In this example, you would have paid a total of $6400 out of pocket (your deductible + coinsurance). If your surgery had cost $31,000, your total out of pocket costs would have been $6900 ($500 + 20% of $30,500).

As you can see, having a higher deductible and lower coinsurance can result in lower out-of-pocket healthcare costs if you don't use many healthcare services in a year. But if you do need to use a lot of healthcare services, having a lower deductible and higher coinsurance may be a better option.

You'll need to decide what type of health insurance plan is right for you based on your needs and budget. If you have any questions about how copays, coinsurance or deductibles work, be sure to ask your health insurance company or agent. They will be able to give you more specific information about your own health insurance plan.

This wraps up our guide to understanding copays, coinsurance and deductibles. We hope this article has been helpful in clearing up any confusion you may have had about these terms.

Some other important things to remember include:

- Your deductible, copay, and coinsurance all count towards your out-of-pocket maximum.

- Many health insurance plans offer free preventive care services.

- You may be able to lower your costs by using in-network providers.

If you have any questions about how these cost sharing methods work, please contact us and we will give you specific information about your plan.

At Triton Health Plans, we do our best in making sure that our clients are well-protected with affordable and comprehensive policies. We make sure to go the extra mile to help you with your needs. To learn more about how we can help you, please contact us at (407) 501-1772 or Click Here to request a free quote or schedule an appointment.

Why You Should Use an Agent to Find Health Insurance

Everything you need to know about health insurance deductibles.

• An emergency room visit typically is covered by health insurance. For patients covered by health insurance, out-of-pocket cost for an emergency room visit typically consists of a copay, usually $50-$150 or more, which often is waived if the patient is admitted to the hospital. Depending on the plan, costs might include coinsurance of 10% to 50%.
• For patients without health insurance, an emergency room visit typically costs from $150-$3,000 or more, depending on the severity of the condition and what diagnostic tests and treatment are performed. In some cases, especially where critical care is required and/or a procedure or surgery is performed, the cost could reach $20,000 or more. For example, at Park Nicollet Methodist Hospital in Minnesota, a low-level emergency room visit, such as for a minor laceration, a skin rash or a minor viral infection, costs about $150 ; a moderate-level visit, such as for a urinary tract infection with fever or a head injury without neurological symptoms, about $400 ; and a high-level visit, such as for chest pains that require multiple diagnostic tests or treatments, or severe burns or ingestion of a toxic substance, about $1,000, not including the doctor fees. At Dartmouth-Hitchcock Medical Center[ 1 ] , a low-level emergency room visit costs about $220, including hospital charge and doctor fee, with the uninsured discount, while a moderate-level visit costs about $610 and a high-level visit about $1,400 .
• Services, diagnostic tests and laboratory fees add to the final bill. For example, Wooster Community Hospital, in Ohio, charges about $170 for a simple suture, $200 for a complex suture, about $170 for a minor procedure and about $400 for a major procedure, not including doctor fees, medicine or supplies.
• A doctor fee could add hundreds or thousands of dollars to the final cost. For example, at Grand Lake Health System[ 2 ] in Ohio, an emergency room doctor charges about $100 for basic care, such as a wound recheck or simple laceration repair; about $300 for mid-level care, such as treatment of a simple fracture; about $870 for advanced-level care, such as frequent monitoring of vital signs and ordering multiple diagnostic tests, administering sedation or a blood transfusion for a seriously injured or ill patient; and about $1,450 for critical care, such as major trauma care or major burn care that could include chest tube insertion and management of IV medications and ventilator for a patient with a complex, life-threatening condition. At the Kettering Health Network, in Ohio, a low-level visit costs about $350, a high-level visit costs about $2,000 and critical care costs almost $1,700 for the first hour and $460 for each additional half hour; ER procedures or surgeries cost $460-$2,300 .
• According to the U.S. Agency for Healthcare Research and Quality[ 3 ] the average emergency room expense in 2008 was $1,265 .
• According to the U.S. Centers for Disease Control and Prevention, in 2008, about 18%of emergency room patients waited less than 15 minutes to see a doctor, about 37%waited 15 minutes to an hour, about 15% waited one to two hours, about 5% waited two to three hours, about 2% waited three to four hours, and about 1.5% waited four to six hours.
• In some cases, the doctor might recommend the patient be admitted to the hospital. The American College of Emergency Physicians Foundation offers a guide[ 4 ] on what to expect.
• An ambulance ride typically costs $400-$1,200 or more, depending on the location and services performed.
• An urgent care center offers substantial savings for more minor ailments. DukeHealth.org offers a guide[ 5 ] on when to seek urgent care. An urgent care visit typically costs between 20% and 50% of the cost of an emergency room visit. MainStreetMedica.com offers a cost-comparison tool for common ailments.
• Hospitals often offer discounts of up to 50% or more for self-pay/uninsured emergency room patients. For example, Ventura County Medical Center[ 6 ] in California offers ER visits, including the doctor fee and emergency room fee but not including lab tests, X-rays or procedures, for $150 for patients up to 200% of the federal poverty level, for $225 for patients between 200% and 500% of the federal poverty level and $350 for patients from 500% to 700% of the federal poverty level.
• The American College of Emergency Physicians Foundation offers a primer[ 7 ] on when to go to the emergency room.
• In most cases, it is recommended to go to the nearest emergency room. The U.S. Department of Health and Human Services offers a hospital-comparison tool[ 8 ] that lists hospitals near a chosen zip code.
•   patients.dartmouth-hitchcock.org/billing_questions/out_of_pocket_estimator_dhmc.ht...
•   www.grandlakehealth.org/index.php?option=com_content&view=article&id=106&Itemid=60
•   meps.ahrq.gov/mepsweb/data_stats/tables_compendia_hh_interactive.jsp?_SERVICE=MEPS...
•   www.EmergencyCareforYou.org/VitalCareMagazine/ER101/Default.aspx?id=1288
•   www.dukehealth.org/health_library/health_articles/wheretogo
•   resources.vchca.org/documents/SELF%20PAY%20DISCOUNT%20GRID%20-%20BOARD%20LETTER%20...
•   www.EmergencyCareforYou.org/YourHealth/AboutEmergencies/Default.aspx?id=26018
•   www.medicare.gov/hospitalcompare/(S(efntd2saaeir2l5pgarwuvvg))/search.aspx?AspxAut...

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Common questions about Medicare annual wellness visits

If you are a Medicare recipient, you can take advantage of annual wellness visits. These visits are a preventive health benefit available after having Medicare Part B coverage for at least one year. All Medicare Advantage Plans are required to offer annual wellness visits for their members. A nurse or nurse practitioner reviews your health status and helps you plan for health and wellness needs.

In most cases, the annual wellness visit will be followed by a separate medical visit  with your primary care professional to close any health care gaps and address any problems identified during the visit.

Here are answers to common questions about annual wellness visits.

Why are annual wellness visits important.

The annual wellness visit allows you to review your health history and identify any current or potential health risks with a health care professional. The visit enables the nurse to focus on prevention and wellness while making sure you are current on recommended immunizations and health screenings like colonoscopies or mammograms. It also allows your primary care professional more time to focus on your medical concerns and needs at a separate physical exam.

Do I need to be 65 or older to have an annual wellness visit?

You do not need to be 65 or older to qualify for an annual wellness visit as long as you've been on Medicare Part B for at least one year.

How is an annual wellness visit scheduled?

If you are due for an annual wellness visit, you may be prompted to self-schedule the visit in the patient portal . You also may call your care team and ask to be scheduled.

If your visit is with a nurse or nurse practitioner, it's recommended to schedule this visit before the visit with your primary care professional. This allows your primary care professional the chance to address any concerns mentioned during your annual wellness visit.

How can I prepare for my annual wellness visit?

You may be asked to complete some questionnaires before arriving for your appointment, which will be sent to your patient portal account. If you cannot access the questionnaires before the appointment, plan to arrive at your appointment early to complete them.

It's helpful to come prepared to your visit with this information:

• All medications, vitamins and supplements you take, including how much and how often you take them
• Additional medical records, including immunization records
• Dates of your most recent preventive services, like a colonoscopy or mammogram, if completed by another health care facility
• Family health history, with as much detail as possible
• List of medical providers and suppliers who provide you care, equipment or services

What can you expect during an annual wellness visit?

During the visit, you'll meet with a nurse or nurse practitioner to:.

• Evaluate your fall risk
• Measure your height, weight and blood pressure
• Offer referrals to other health education or preventive services
• Provide information related to voluntary advance care planning
• Screen for cognitive impairments like dementia
• Screen for depression
• Update your medical and family history

What is the cost of an annual wellness visit?

Medicare offers the visit at no cost for people who have Medicare Part B coverage for at least one year before the visit. If you are referred for other tests or services, they will be billed to your insurance. If you have a separate visit with your primary care professional following your annual wellness visit, you or your insurance carrier will be responsible for the cost of that visit.

Robert Stroebel, M.D. , is a Community Internal Medicine, Geriatric and Palliative Care physician at Mayo Clinic Primary Care in Rochester and Kasson, Minnesota.

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What to Expect at Your Annual Wellness Visit

Once a year, you make an appointment with your primary care physician to make sure your health is in good working order and detect potential concerns early, before symptoms are noticeable.

To schedule your annual wellness or follow-up office visit with a provider in Primary Care, please visit here or login to Connect .

Most insurance plans cover your annual wellness exam — no copay required. However, you may find the actual components of a wellness visit a bit confusing.

Review the FAQs below to learn what to expect during your next annual wellness visit.

Frequently Asked Questions

What is included in a wellness visit.

Your annual wellness visit includes the following:

• A review of your medical and surgical history
• Screenings - we generally follow screening recommendations of the USPSTF
• Blood tests
• Immunizations - we follow the vaccine schedules published by the CDC
• A physical exam
• Counseling to prevent future health problems 

How should I prepare for my visit?

Please check in via Connect up to 5 days before your visit to make sure we have your most up-to-date information, including your medications, medical history and insurance. You will be able to update these, along with your preferred pharmacy. You can also review and update your responses to your health questionnaire.

Please fast for at least 4 hours prior to your visit. You may drink water or black coffee, and take your maintenance medications.  Pediatric and Gynecology patients should not fast.

On the day of your appointment, please arrive on time and bring your insurance card and ID.

What if I need to ask my doctor about a specific medical issue?

Specific issues are considered part of a follow-up or “sick” visit. These aspects of your visit will be billed to your insurance, and you may be responsible for copayments, coinsurance or deductible payments, based on the terms of your policy.

If you would like to address non-routine concerns during your wellness visit, you can let your doctor know about these issues when you schedule your appointment. Depending on their complexity, the questions may need to be dealt with at a later time.

What does a follow-up or “sick” visit include?

• Treatment of a chronic condition such as diabetes, asthma or high blood pressure
• Any new problems or complaints
• Your need for new medications or tests
• Referrals to a specialist
• Additional treatment options

What is a Medicare annual wellness visit and what does it include?

The Medicare annual wellness visit, covered by Medicare, allows your health-care provider to conduct a health risk assessment and propose screenings and prevention strategies. As well, your provider will make sure all your immunizations, cancer screenings and other screenings are discussed and scheduled.

Your Medicare wellness visit does not include a detailed physical exam or management of chronic or new medical problems . Your physician may be able to perform a complete physical and address new or existing medical issues during your Medicare annual wellness visit, but you could incur additional charges.

What to expect during your Medicare annual wellness visit

At your Medicare annual wellness visit, your health care provider will:

• Review your blood pressure, heart rate, height, weight and body mass index (BMI).
• Review your current health problems, as well as your medical, surgical, family and social histories.
• Review your current medications.
• Conduct a health risk assessment.
• Provide nutrition counseling.
• Discuss an exercise plan to fit your lifestyle.
• Discuss smoking cessation and arrange for counseling, if needed.
• Discuss fall prevention.
• Discuss advance care planning.
• Discuss preventive screenings recommended by evidence-based practice guidelines that are indicated for you based upon your age, risk factors and family history

How to prepare for your Medicare wellness visit

Bring these items to your visit:

• Immunization records
• A list of current prescribed medicines, supplements and over-the-counter medications
• A list of your patient care team—any specialists you see for various types of care
• Be prepared to review your family medical history.

Can I combine a Medicare or non-Medicare wellness visit with a follow up visit?

Combining a wellness visit with a follow-up office visit will save you time by eliminating an extra appointment, but doing so may affect your costs. Additional concerns beyond a wellness visit may be billed to your insurance, which can  result in unplanned out-of-pocket costs to you. For these reasons, Weill Cornell Primary Care recommends that you schedule your annual wellness visit and any follow-up or sick office visits separately.

What are the most important points I need to keep in mind?

• Review your insurance plan’s summary of benefits before your appointment to understand what your insurance company will or will not cover.
• When scheduling a wellness visit, clearly state that you would like to make an appointment for your annual wellness or preventive care exam. That will help the practice prepare for your visit and bill your insurance company appropriately.
• When you speak with your doctor or other practitioner, let them know you are there for a wellness exam. Or, if you need to discuss a specific concern that may require treatment, make sure to bring their attention to any non-routine concerns at the start of your appointment.

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How Much Does a Doctor Visit Cost With and Without Insurance?

Without insurance, medical care can get pricy fast. Where you live, what doctor you’re going to, and what tests you need will all figure into your doctor’s visit bill. In this article, we’ll break down those costs and give you some tips for saving money.

What Goes into the Cost of a Doctor’s Visit?

Geography is one of the biggest factors in the price of a doctor’s visit. Most medical facilities pass some of their overhead expenses onto their patients. If you live somewhere with a higher cost of living, like California or New York City, you’ll likely pay more for doctors’ visits. The practice has to pay more for utilities and rent, and those costs show up in your bill. For example, Mayo Clinic’s Patient Estimates tool quotes $846 for a 60-minute office visit in Jacksonville, Florida, but $605 for the same visit in Wisconsin.

Like the cost of living, supplies and equipment will also end up on your tab. Say you need a strep test, blood draw, or Pap smear. The supplies needed for the test plus the cost of the lab fees will all figure into the price.

Bills for the same exams and procedures can also vary depending on what kind of facility you’re going to. Smaller practices and public health centers are often a lot cheaper than university or private hospital systems. This is due in part to their buildings being smaller and their overhead fees being lower.

Price of Out-of-Pocket Doctors’ Visits

The cost of a doctor’s office visit also depends on what kind of doctor and the procedure you need to have done. For example, an in-office general wellness checkup will be cheaper than a specialist procedure. If you have an emergency, an urgent care center will be much more affordable than the emergency room.

Primary Care Physician — Physical Exam

Physicals usually include blood pressure readings, cholesterol measurements, and vaccines. Prostate exams for men and Pap smears and breast exams for women are also often included. Pediatric physicals focus on the growth milestones for your child’s age. Doctors check height, weight, sleep patterns, diet, and the vaccines required by public schools.

The range for a yearly physical can be anywhere from $100 to $250 or more without insurance. A CVS Minutecare Clinic may charge just $59 for a sports physical, but not all organizations will accept this as proof of physical health.

Primary Care Physician — Procedures

On top of the base cost for physical exams, you may have extra charges for any specific tests or procedures you need. According to the Cardiometabolic Health blog, the most common procedures in primary care medicine include bloodwork, electrocardiograms, and vaccines/injections.

Bloodwork is one of the biggest cost wild cards. Certain tests can run you from as little as $10 to as much as $10,000 . Large national labs like Labcorp offer pricing on their website, so you know what to expect going in. For example, Labcorp’s General Health Blood Test , which includes a metabolic panel, complete blood count (CBC), and urinalysis, costs $78.

Electrocardiograms or EKGs check your heart health and can find cardi ac issues. This quick procedure involves monitoring your heartbeat through electrodes placed on your skin. While it’s a painless and accurate way to detect heart conditions, the costs can add up without insurance. Expect to pay as little as $410 or as much as $1700 for this procedure, depending on local prices.

Vaccines are often required before sending your kids to school. The CDC publishes a vaccination price list annually to give you an idea of what to expect. For example, they quote $19-$132 for DTaP, $21 for Hepatitis A, and $13-$65 for Hepatitis B. The COVID-19 vaccine, however, is free of cost, regardless of insurance status.

Urgent Care Visit

If you have an emergency but are stable, urgent care is much cheaper than the emergency room. According to Scripps , most urgent care centers and walk-in clinics can at least treat dehydration, cuts or simple fractures, fever, flu, strep, and UTIs. Note that if you have chest pain, a serious injury, seizures, a stroke, or pregnancy complications, you should go straight to the ER .

For a base exam at an urgent care facility, expect to pay between $100-$150 . That price will go up depending on what else you need. For example, Advanced Urgent Care in Denver quotes $80 for an X-Ray, $50 for an EKG, $135 for stitches, and $5 for a urinalysis. In comparison, expect to pay $1,000-$1,300 for the same procedures in the emergency room.

How to Lower Your Out-of-Pocket Medical Costs

Healthcare expenses may seem overwhelming without insurance. Luckily, there are many resources available to help you cover the costs.

Free & Low-Cost Immunization and Wellness Clinics

For standard vaccines and checkups, look for local free or low-cost clinics. Check out The National Association of Free and Charitable Clinics’ search tool to find a location near you. Your city’s public health department should also offer free or low-cost vaccines and basic medical care services.

Certain large vaccine manufacturers also offer vaccine programs. For example, Merck’s patient assistance program offers 37 vaccines and medicines free to eligible patients. The program includes albuterol inhalers and vaccines for Hepatitis A, Hepatitis B, MMR, and HPV.

Cash Negotiations

Most health systems offer lower rates for patients paying cash. Some even have free programs for low-income families. For example, Heritage UPC in North Carolina has a yearly membership for low-cost preventative care. In Northern California, the Sutter Health medical system offers full coverage for patients earning 400% or less of the Federal Poverty Income Guideline .

As of January 1, 2021, all hospitals in the United States now have to follow the Hospital Price Transparency Rule . That means they have to list procedure prices clearly on their website. You can also call medical billing before your appointment to discuss cash pay options.

Federal Medical Payment Support

If all else fails, there are federal programs to help you cover the cost of medical bills.

Organizations like The United Way and United for Alice offer grants for ALICE (asset-limited, income-constrained, employed) patients. These are people living above the poverty level, making them ineligible for other government programs but below the basic cost-of-living threshold.

Medicaid is available for children, pregnant women, and adults under a certain income threshold. If your income is too high to qualify for Medicaid but you can’t afford private insurance for your children, you may be eligible for the Children’s Health Insurance Program (CHIP) to cover your children’s medical care.

Use Compare.com for the Best Doctors’ Visit Prices

Navigating bills for a doctor’s visit can feel overwhelming, but Compare.com is here to help. With our price comparison tool, you can search all clinic and doctors’ office prices in your area. Compare makes sure you’re prepared for the cost of your checkup long before you schedule your appointment.

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What is a copay & when do you have to pay it?

A set amount that you pay any time you receive certain medical services

Updated April 30, 2021 | 4 min read

Policygenius content follows strict guidelines for editorial accuracy and integrity. Learn about our editorial standards and how we make money .

Table of contents

Copays vs coinsurance

Copays vs deductible, copays and out-of-pocket max, copays with medicare and medicaid.

A copay is a flat fee that you pay when you receive specific health care services, such as a doctor visit or getting prescription drugs . Your copay (also called a copayment) will vary depending on the service you receive and your health insurance plan, but copays are typically $30 or less.

Copays are a form of cost sharing. Insurance companies use them as a way for customers to split the cost of paying for health care. Copays for a particular insurance plan are set by the insurer. Regardless of what your doctor charges for a visit, your copay won't change.

Key takeaways

A copay is a flat fee you pay whenever you receive certain health care services or get prescription drugs

Copays may apply before and *after* you hit your deductible

A copay is different from coinsurance, which only applies after reaching your deductible and is the percentage of your final bill that you pay

Not all services require a copay — preventive care usually doesn’t — while the copay for other medical services may depend on which doctor you see or which medicine you use. In particular, certain insurance plans charge more to visit a specialist physician instead of your primary care physician. Name brand prescription medicine usually has a higher copay than generic versions.

As a general rule, health insurance plans with lower monthly premiums (the amount you pay each month in order to have health insurance) will have higher copays. Plans with higher premiums usually have lower copays.

Ready to shop health insurance?

Copays and coinsurance are two ways that insurance companies share costs with customers, but they differ in both how and when they apply.

As mentioned, a copay is a set amount of money that you pay when you receive a certain service. The amount of your copay varies based on the service. An office visit for your primary care physician may have a $20 copay, while filling an order for prescription drugs may have a $25 copay. No matter how much the doctor or provider charges for the service your copay is the same.

On the other hand, coinsurance is charged as a percentage instead of a flat fee. For example, let’s say you have coinsurance of 20%. That means you need to pay 20% out of pocket, and then your insurance will cover the other 80% of the bill. (This is also referred to as 80/20 coinsurance.) Your coinsurance will also apply in addition to your copay.

Another important difference is that copays may apply regardless of whether you’ve met your deductible, but you only pay coinsurance after you’ve reached your deductible or if you see an out-of-network provider. The major exception is if you have a zero-deductible plan, which will always require you to pay coinsurance.

Before you hit your deductible, you will have to pay out of pocket when you go to the emergency room or if you require urgent care, like a medical procedure. (If you need care to treat a life threatening situation, your insurance will cover the cost because of the essential health benefits that Obamacare requires insurers to cover.)

The following table highlights some key differences between a copay and coinsurance .

Outside of clinic visits and preventive care, certain medical procedures are subject to a deductible. Your health insurance deductible is the amount of your own money that you need to pay for those procedures before your insurance company will step in to pay for some of your medical expenses.

A high deductible means you pay more yourself before your insurance steps in. What expenses count toward meeting your deductible may vary by plan, but copays do not usually count toward your deductible .

Learn more about deductibles .

A high deductible means you pay more yourself before your insurance steps in. What expenses count toward meeting your deductible may vary by plan, but copays do not usually count toward your deductible.

Your out-of-pocket maximum, also called your out-of-pocket limit , is the maximum amount you will have to pay on your own for medical expenses if you have health insurance. Once you hit that spending amount, your insurer will take over to cover the rest of your costs for the calendar year. Your spending towards the limit will reset once a new year starts.

Copays do count toward your annual out-of-pocket maximum since they are all out-of-pocket expenses . You don’t usually have to make copays after you hit your maximum, but this varies by plan. Check the details of your specific plan for more information.

Learn more about what counts toward your out-of-pocket maximum .

If you have Medicare , the federal health insurance program for people who are older than 65 or have certain disabilities, you can generally expect to pay less in copays than you would pay for private health insurance or other individual plans from the marketplace. Prices vary by plan but your copays, like for a prescription drug, could be less than $5.

Medicaid plans vary by state, so you should check your individual plan to see what the copays are. However, copays with Medicaid are generally much smaller than they are with other plans. For example, in New York, the copay is $3 for visiting a clinic or getting a brand name subscription.

Read more on who qualifies for Medicaid in our state-by-state guide to Medicaid .

Derek Silva

Senior Editor & Personal Finance Expert

Derek is a former senior editor and personal finance expert at Policygenius, where he specialized in financial data, taxes, estate planning, and investing. Previously, he was a staff writer at SmartAsset.

Questions about this page? Email us at  [email protected] .

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Does Medicare cover doctor visits?

Medicare Part B is the part of original Medicare that covers the costs of doctor visits. Part C, or Medicare Advantage, also provides this coverage.

Medicare is a federally funded insurance plan consisting of four parts: Part A, Part B, Part C, and Part D . Each part covers different medical expenses.

In 2020, Medicare provided healthcare benefits for more than 61 million older adults and other qualifying individuals.

Today, it primarily covers people who are over the age of 65 years, but younger people with end stage kidney disease and those with certain disabilities are also eligible.

This article explains which parts of Medicare cover doctor visits, what types of appointments they cover, and how much the plans cost.

We may use a few terms in this piece that can be helpful to understand when selecting the best insurance plan: Deductible: This is an annual amount that a person must spend out of pocket within a certain time period before an insurer starts to fund their treatments. Coinsurance: This is a percentage of a treatment cost that a person will need to self-fund. For Medicare Part B, this comes to 20%. Copayment: This is a fixed dollar amount that an insured person pays when receiving certain treatments. For Medicare, this usually applies to prescription drugs.

What parts of Medicare cover doctor visits?

Original Medicare comprises Part A, which is hospital insurance, and Part B, which covers many medical services, including doctor visits.

Medicare Part B

Medicare Part B covers two types of services: medically necessary and preventive.

Medically necessary services are those that the doctor uses to identify a medical condition when someone presents with symptoms and to provide them with treatment.

Preventive care helps prevent illnesses or stop early stage conditions from progressing. This type of care includes flu shots and screenings, such as cholesterol checks, Pap smears , and mammograms.

Some preventive services have no associated costs when a doctor agrees to accept assignment. This means that the doctor has a contract to bill Medicare directly.

Part B may also pay for other services, such as an ambulance, certain prescription drugs, and durable medical equipment. People can check whether their plan covers the test or service they need using Medicare’s online tool .

Medicare Part C (Medicare Advantage plans)

Medicare Part C plans, also known as Medicare Advantage plans, are an all-in-one alternative to original Medicare that private insurance companies administer. These plans must provide the same coverage level as original Medicare, including coverage for visits to the doctor.

Medicare sends payment directly to the doctor, although individuals may need to pay a coinsurance and meet a deductible. These costs vary by plan.

Medicare resources

For more resources to help guide you through the complex world of medical insurance, visit our Medicare hub .

When does Medicare not cover doctor visits?

Medicare typically does not cover certain services and doctor’s appointments, including :

• podiatry, which can involve callous removal, corn removal, or toenail trimming
• optometry, including regular eye health checkups and getting a new prescription
• naturopathic medicine, including acupuncture — unless it is to treat lower back pain
• dental services, although Medicare Advantage may cover some dentistry
• most chiropractic services , unless they are for spinal subluxation

Part B may limit coverage to a set number of services in a year or lifetime. For example, a person can have blood tests to screen for heart disease once every 5 years .

How much does Medicare pay for a doctor visit?

Everyone with Medicare is entitled to a yearly wellness visit that has no charge and is not subject to a deductible.

Beyond that, Medicare Part B covers 80% of the Medicare-approved cost of medically necessary doctor visits. The individual must pay 20% to the doctor or service provider as coinsurance.

The Part B deductible also applies, which is $203 in 2021. The deductible is the amount of money that a person pays out of pocket before the insurance begins to cover the costs.

A person will also need to pay a premium to keep the policy. The standard monthly premium in 2021 is $148.50.

If a person did not sign up when they were eligible at the age of 65 years, they might also need to pay a late enrollment penalty. This penalty can increase the premiums by 10% for each year that someone qualified for Medicare but did not enroll.

The costs associated with Medicare Advantage Plans vary depending on several factors, including:

• whether the plan has a premium
• whether the plan pays the Medicare Part B premium
• the yearly deductible, copayment, or coinsurance
• the annual limit on out-of-pocket expenses
• the type of healthcare services a person needs

Medicare Part B and Medicare Advantage plans cover visits to the doctor. These plans help people with health insurance plans pay for medically necessary and some preventive care.

Medicare does not limit the number of times a person can see their doctor, but it may limit how often they can have a particular test and access other services.

People can contact Medicare directly on 800-MEDICARE (800-633-4227) to discuss physician coverage in further detail.

A note on insurance

The information on this website may assist you in making personal decisions about insurance, but it is not intended to provide advice regarding the purchase or use of any insurance or insurance products.

Healthline Media does not transact the business of insurance in any manner and is not licensed as an insurance company or producer in any U.S. jurisdiction. Healthline Media does not recommend or endorse any third parties that may transact the business of insurance.

Last medically reviewed on June 25, 2021

• Health Insurance / Medical Insurance
• Medicare / Medicaid / SCHIP
• Primary Care

How we reviewed this article:

• Doctor & other health care provider services. (n.d.). https://www.medicare.gov/coverage/doctor-other-health-care-provider-services
• Items & services not covered under Medicare. (2020). https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/Items-Services-Not-Covered-Under-Medicare-Text-Only.pdf
• Medicare Advantage plans. (n.d.). https://www.medicare.gov/sign-up-change-plans/types-of-medicare-health-plans/medicare-advantage-plans
• Medicare costs at a glance. (n.d.). https://www.medicare.gov/your-medicare-costs/medicare-costs-at-a-glance
• Part B costs. (n.d.). https://www.medicare.gov/your-medicare-costs/part-b-costs
• Part B late enrollment penalty. (n.d.). https://www.medicare.gov/your-medicare-costs/part-b-costs/part-b-late-enrollment-penalty
• Total number of Medicare beneficiaries. (n.d.). https://www.kff.org/medicare/state-indicator/total-medicare-beneficiaries/?currentTimeframe=0&selectedDistributions=total&selectedRows=%7B%22wrapups%22:%7B%22united-states%22:%7B%7D%7D,%22states%22:%7B%22all%22:%7B%7D%7D%7D&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D
• Your Medicare benefits. (2021). https://www.medicare.gov/Pubs/pdf/10116-Your-Medicare-Benefits.pdf
• What part B covers? (n.d.). https://www.medicare.gov/what-medicare-covers/what-part-b-covers
• What's Medicare? (n.d.). https://www.medicare.gov/what-medicare-covers/your-medicare-coverage-choices/whats-medicare

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What Is the Medicare Annual Wellness Visit?

• How the Medical Wellness Visit Works
• Types of AWVs

Routine Physical Exam vs. AWV

• Requirements
• Frequently Asked Questions (FAQs)

The Bottom Line

• Health Insurance
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Medicare Annual Wellness Visit: What Is It?

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The Medicare annual wellness visit is a free preventive benefit available to Medicare beneficiaries every 12 months. Both Original Medicare and Medicare Advantage offer this visit with your doctor to review your mental and physical health and cognitive abilities. Together, you create a personalized plan to address concerns based on your current health and any risk factors. 

Key Takeaways

• The Medicare annual wellness visit is a check-in every 12 months with your healthcare provider.
• Your provider assesses your current and recent physical and mental state and looks for potential risk factors. 
• The annual wellness visit isn’t an appointment to address new health concerns or symptoms. Bringing these up could lead to additional charges from your doctor’s office.
• Both Original Medicare and Medicare Advantage plans offer Medicare annual wellness visits.

How the Medical Wellness Visit Works 

The annual wellness visit includes a health risk assessment, a review of your medical and family health history, a collection of your current healthcare providers and suppliers, and a self-assessment of your health status.

In advance, the doctor will likely give you a questionnaire. It takes about five minutes to fill out.

The Medicare annual wellness visit attempts to uncover any changes impacting your ability to care for yourself (such as dressing, shopping, and financial management ) and increased health risks from behavioral factors (smoking, physical activity, seat belt use) and emotional factors (depression, anger, loneliness).

The doctor will measure and document: 

• Demographic information
• Body mass index (BMI) or waist circumference
• Blood pressure
• Other measurements based on medical and family history
• Any cognitive impairments
• Potential depression risk factors
• Ability to perform daily activities
• Risk of a fall 
• Any hearing impairment
• Potential substance use disorders and opioid prescriptions
• Other safety concerns

Using this information, the doctor helps maintain a screening schedule based on your risk factors and conditions. You’ll get personalized advice and referrals to health services and programs to help address physical safety and mental health issues and control risk factors such as smoking.  

Your wellness visit can also include advance care planning, also known as advance directive planning. This is a face-to-face conversation between you and your healthcare professional about your healthcare wishes and medical treatment preferences should you become unable to communicate or make decisions about your care. 

You won’t pay anything for your visit (including the Part B deductible) if your doctor accepts the Medicare assignment. 

But to have the visit remain free, you’ll also need to stay within the Medicare annual wellness visit’s boundaries of discussion topics. Don’t talk about your new knee ache; make a separate appointment for that. 

If your doctor orders additional tests or services outside the scope of a Medical wellness visit, you will have to pay the coinsurance and Part B deductible for those tests. 

Types of Medicare Annual Wellness Visits

There are two types of Medicare annual wellness visits (AWVs)—the initial AWV and follow-up AWVs that happen in subsequent years. 

Your first Medicare annual wellness visit will be more thorough than later ones. It will include establishing a baseline regarding your physical and mental health history, risk factors, and any signs of cognitive impairment. You'll also set up a personalized screening schedule going forward. The doctor will discuss your advance care planning if you wish. 

After the first visit, the wellness visits review and update changes to the above, including:

• Health risk assessment
• Medical and family history 
• Current providers and suppliers
• Weight and blood pressure measurements
• Cognitive impairment assessment
• Written screening schedule 
• Risk factors and interventions 
• Referrals to services and programs
• Advance care planning
• Opioid prescriptions 

Your annual wellness exam reviews your personalized prevention plan of services and is focused on managing health risks. Medicare covers an annual AWV 12 months after the last AWV (date of service), paying all costs as long as the doctor accepts Medicare. The AWV can also incorporate advance care planning discussions.

In comparison, a routine physical is a medical exam performed without addressing treatment or diagnosis for a specific illness, symptom, complaint, or injury. 

Original Medicare does not cover routine physical exams; patients must pay all costs out of pocket. However, some Medicare Advantage plans cover annual physicals.

Physical exams don’t typically include discussions of advance care planning. However, the AWV and other Medicare benefits cover some aspects of the routine physical, so you may see some overlap.

Requirements for the Medicare Annual Wellness Visit

For Medicare to cover your Medicare annual wellness visit, it must be performed by a physician (doctor of medicine or osteopathic medicine) or a nurse practitioner, physician assistant, or clinical nurse specialist. 

You must have been enrolled in Medicare Part B for more than 12 months. In other words, your first yearly wellness visit can’t occur within 12 months of your Part B enrollment. 

Your Medicare annual wellness visit also can’t take place within 12 months of your “Welcome to Medicare” preventive visit, which happens when you first join Medicare. That visit reviews your health-related medical and social history and provides education on preventive services. The “Welcome to Medicare” visit is called the Initial Preventive Physical Exam or IPPE.

However, to qualify for your annual wellness visit, you don’t need to have completed the “Welcome to Medicare” preventive visit.

To prepare for your Medicare annual wellness visit, you’ll need to bring: 

• Medical records
• Immunization records
• Family health history
• A list of all medications, supplements, and vitamins, and information on how often and how much of each you take
• A list of your current healthcare providers and suppliers, including mental health specialists

Frequently Asked Questions (FAQs) 

What’s the difference between a medicare wellness visit and an annual physical.

A wellness visit isn’t designed to incorporate a full panel of lab tests and in-office exams. It’s more of a quick check-in with your doctor using Medicare’s standardized list of questions concerning your overall mental and physical health and your ability to care for yourself. 

Does the Medicare Wellness Exam Include Blood Work?

No, the Medicare Annual Wellness Exam’s coverage doesn’t include clinical lab tests. Your doctor could make a referral for blood tests or lab tests as part of the AWV. Medicare Part B typically covers medically necessary lab work, such as blood tests.

Does Medicare Cover an Annual Physical?

Some Medicare Advantage plans cover an annual physical, but Original Medicare does not. However, Original Medicare Part B does cover dozens of preventive tests, screenings, and services that are usually part of a routine preventive physical, including screening for: 

• Colorectal cancer, prostate cancer, and breast cancer 
• Abdominal aortic aneurysms (via ultrasound)
• Cardiovascular disease 

The Medicare annual wellness visit allows you to discuss your overall health, quality of life, mental health, mood, and ability to think with your doctor. Your care provider can watch for changes and order more tests or help with necessary interventions. Catching problems early can keep you healthier and help you avoid expensive treatments later on. 

Centers for Medicare and Medicaid Services. “ Medicare Wellness Visits .”

Medicare.gov. “ Yearly ‘Wellness’ Visits .”

Medicare.gov. “ Preventative and Screening Services .”

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Knights, fighting for better playoff position, pay Jets a visit

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After capturing three of four possible points on a difficult back-to-back to start their four-game road trip, the Vegas Golden Knights continue their quest to improve their playoff standing when they visit the Winnipeg Jets on Thursday night.

Vegas (39-25-8, 86 points) currently holds the second wild-card spot in the Western Conference, sitting six points ahead of the St. Louis Blues.

In the Pacific Division, the Golden Knights are four points behind the second-place Edmonton Oilers, who have two games in hand, and one point behind the third-place Los Angeles Kings, who have one game in hand.

The Golden Knights opened the trip with a 2-1 overtime victory over the Blues on Monday. Vegas looked to be in good shape to complete a sweep of the back-to-back when it took a 4-1 lead into the third period against Nashville on Tuesday.

However, the Predators rallied for three third-period goals in a span of just over seven minutes, then won 5-4 on a Roman Josi goal 40 seconds into overtime.

"We had a great 40 minutes," Vegas defenseman Noah Hanifin said. "It's just playing that complete 60 is something we have to get better at, obviously."

Blowing the big lead cost Vegas a chance to head into the contest with the Jets in a tie with Los Angeles for third in the Pacific at 87 points.

"The points are really important for us right now," said Golden Knights forward Ivan Barbashev, who scored his 100th career goal on Tuesday. "We got one of them (Tuesday). We've just got to keep going forward trying to forget about (the game against Nashville)."

Hanifin isn't dwelling on the past, either.

"Obviously we have two huge games coming up again," Hanifin said, referring to the meeting with the Jets and a Saturday game against the Minnesota Wild. "It's unfortunate (to blow the lead), but we've got to turn the page, get a good day of rest (Wednesday) and get ready to go because we're going to have a big test on Thursday."

Winnipeg (44-22-6, 94 points) sits in third in a very competitive Central Division race -- five points behind the first-place Dallas Stars and three behind the second-place Colorado Avalanche. Dallas has played one more game than Colorado and Winnipeg.

The Jets are in the midst of a four-game winless streak (0-3-1), including a 4-3 overtime loss to the Edmonton Oilers on Tuesday.

Unlike Vegas, Winnipeg came away feeling somewhat positive following the setback after rallying from a 3-1, third-period deficit. Zach Hyman scored 1:22 into the extra period to win it for Edmonton.

"I thought ... it was a good effort by us, but at the end of the day we need to get two points out of them," said Jets defensemen Brenden Dillon, who sparked the rally against the Oilers with a goal 9:39 into the third. "We just continue to prove to ourselves throughout this year, through now 72 games, when we're on our game, when we're playing the way that we talk about Winnipeg Jet hockey, we're an elite team."

Thursday marks the third and final meeting of the season between the teams. The Golden Knights won 5-3 at Winnipeg on Oct. 19 and 5-2 in Las Vegas on Nov. 2.

--Field Level Media

Copyright 2024 STATS LLC and Associated Press. Any commercial use or distribution without the express written consent of STATS LLC and Associated Press is strictly prohibited.

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11 Low-Stress Jobs That Pay Well

Posted: March 25, 2024 | Last updated: March 25, 2024

Most jobs are stressful at times. Some jobs are stressful most of the time — like a trauma surgeon’s. Working retail is also often stressful, although in a very different way.

It would be nice if we all got paid extra to deal with stressful situations. Life generally doesn’t work that way — but how about a job where you can average six figures without being too stressed?

Such jobs definitely exist. We found them by combing through data from the U.S. Bureau of Labor Statistics and the O*NET occupational database, focusing on jobs that pay at least $100,000 per year on average and that have an O*NET stress tolerance score of 65 or less.

Following are several jobs with high pay and relatively low stress.

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Environmental engineers

Stress score : 65 out of 100

Average pay : $101,670 per year

Median pay: $96,530 per year

Environmental engineers solve problems that would otherwise cause health and safety issues. They do things like building systems for dealing with air pollution and ensuring clean drinking water, and they usually have a bachelor’s degree.

Statisticians

Stress score : 64 out of 100

Average pay : $105,510 per year

Median pay: $98,920 per year

A statistician uses data to identify trends and explain the meaning behind numbers and surveys. Their work can help inform decisions made in business, education, health care and government. A master’s degree is usually required in this line of work.

Average pay : $128,180 per year

Median pay: $113,940 per year

Economists analyze financial policy and spending and sometimes use their research to make forecasts about what might happen in new conditions. This can be particularly useful in business and government. Entry-level work in this field tends to require a master’s degree.

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Economics teachers (postsecondary)

Stress score : 63 out of 100

Average pay : $122,750 per year

Median pay: $103,930 per year

Economics teachers at the postsecondary level offer college and university students courses in understanding financial policy and spending trends. Depending on where they teach, a master’s degree or doctorate is usually necessary.

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Bioengineers and biomedical engineers

Average pay : $108,060 per year

Median pay: $99,550 per year

A bachelor’s degree is the gateway into this field, where workers may develop new medical equipment, train others to use it, or conduct technical research related to things like the effectiveness of drugs or medical treatments. Higher education is needed for certain roles.

Stress score : 62 out of 100

Average pay : $150,130 per year

Median pay: $142,850 per year

Physicists work with the principles of matter and energy, sometimes to study the way things work and other times to solve specific problems that make our technology function, like how to send communications over long distances or keep food cold. You usually need at least a bachelor’s degree, and research jobs typically require an advanced education.

Materials scientists

Average pay : $110,690 per year

Median pay: $104,380 per year

In applied research, materials scientists figure out things like squeezing more power into a smaller battery or making materials withstand heat better. Others study what things are made out of. You’ll likely need at least a bachelor’s degree for these positions, if not more education.

Chemical engineers

Stress score : 61 out of 100

Average pay : $117,820 per year

Median pay: $106,260 per year

This type of engineer might work on ways to handle dangerous chemicals safely in the process of manufacturing electronics or clothes or gasoline. A bachelor’s degree along with some practical experience are usually necessary to land a job.

Computer systems analysts

Stress score : 60 out of 100

Average pay : $107,530 per year

Median pay: $102,240 per year

Another name for this job is “system architect.” They study how computer systems work and how to make them work better. Analysts often have a bachelor’s degree in computer science or information systems, though sometimes in other fields as well.

Stress score : 57 out of 100

Average pay : $127,580 per year

Median pay: $113,990 per year

Actuaries use math and statistics to study what might happen under certain conditions or how likely those conditions are to exist. Most of them work in the insurance industry and have a bachelor’s degree in math or another analytical field.

Mathematicians

Stress score : 56 out of 100

Average pay : $113,860 per year

Median pay: $112,110 per year

Mathematicians analyze data, sometimes inventing computational models to do so. The work may stay that abstract, but sometimes it involves working with other specialists like chemists and engineers who need mathematical help studying or solving a specific problem. Assume you’ll need a master’s degree for this line of work.

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'Buy now, pay later' goes from niche to normal as young people use it for daily essentials

Buying now and paying later is still a popular way to splurge on airfare to Cabo. It’s an increasingly common way to buy groceries and lawn furniture, too.

Consumers ages 35 and under comprise 53% of “buy now, pay later” users but just 35% of traditional credit card holders, according to LexisNexis Risk Solutions. Many of those core “BNPL” borrowers have grown so comfortable using the installment loans for just-out-of-reach luxuries that they’re putting more everyday purchases on them as well.

Apparel and accessories were the most popular product category among millennial (ages 30-44) and Gen Z (18-29) users of the BNPL provider Afterpay in 2021 and 2022. But last year it fell to fourth place behind “arts, travel and entertainment,” “home and garden” and “hardware,” according to data the company provided to NBC News.

The shift adds to signs that fast-growing BNPL services, which let users break up transactions into several payments with little or no interest, are becoming a routine tool in young adults’ wallets as they adapt to higher prices .

Afterpay’s youngest users’ spending on many staples has surged by double and triple digits, with contact lenses soaring 465% from 2022 to 2023, garbage bags jumping 182% and first-aid antiseptics rising 98%. Their spending growth for lighter fluid, laptop parts and snoring and sleep apnea aids all surpassed 300%.

Young borrowers are making similar moves on rival services, too. Benjamin Espinoza, 27, recently stocked his fridge using a discount promotion from Instacart and selected Klarna at checkout, using the BNPL provider to spread out his roughly $40 bill.

It sucks that these are the avenues that I have to go through.

Klarna user Benjamin Espinoza, 27

“It sucks that these are the avenues that I have to go through,” said the San Antonio, Texas, video editor, who lives with three roommates.

Espinoza said he made less than $7,000 last year after earning his bachelor’s degree in history two years ago. He acknowledged most BNPL services don’t help consumers build credit for timely repayment but said, “It’s good that it’s here in the moment.”

Jasmine Parker, 30, also uses Klarna for groceries, including when she’s waiting for a paycheck. It allows her to buy everything she wants rather than forgo a few items, but she said she usually pays her full balance after the second installment comes due “so I don’t have to worry about it.”

“I don’t like owing a bunch of money,” said Parker, who works in customer service and lives in the Raleigh-Durham area of North Carolina, adding that the thought of her student loans stresses her out.

It isn’t just BNPL borrowers in their 20s and 30s making the shift toward essentials. Grocery purchases by shoppers of all ages have expanded their slice of online BNPL loans by 40% since this time last year, according to Adobe — a bigger jump than any other product category — while electronics’ share shrunk by 14%.

Some users on TikTok and X, formerly Twitter, have been trading BNPL-based grocery hacks to cope with higher costs.

“Being able to use afterpay for groceries is a finesse,” one X user posted in December. “Just buy an e giftcard to the grocery store and send it to yourself.” Afterpay said gift cards and certificates are the second-fastest-growing purchase in its arts and entertainment category by millennial and Gen Z customers.

Many borrowers have flocked to BNPL to avoid credit cards with interest rates of 20% or higher . But younger users’ opting to pay for more necessities in installments also reflects the mini-loans’ growing ubiquity in an economy where many consumer prices have swelled.

BNPL providers “got integrated really well and really quickly” into mobile shopping during the pandemic recovery, said Vivek Pandya, lead analyst at Adobe Digital Insights. The services now “have consumers who are very plugged in. So that convenience factor, the ease with which they can kind of move through the BNPL payment process, through their online transaction, has really kept the growth persistent.”

Most BNPL services make money by charging commission fees from merchants when customers apply one of their instant loans at checkout. Afterpay’s retail partners include sellers of household staples such as 1-800-Contacts and PetSmart. In December, rival provider Affirm announced it was expanding to self-checkout kiosks at Walmart’s 4,500 U.S. stores, bringing the option within closer reach of shoppers stocking up on basics.

Nonessentials are still growing fast on BNPL services, too.

Afterpay said travel ticket spending surged 1,430% from the previous year among its youngest users. Affirm told NBC News those purchases are taking off on its platform as well: Travel and ticketing was Gen Zers’ fastest-growing category last year and nearly doubled in volume overall. It was among the fastest-growing purchases for millennials as well, but their top category by volume was “general merchandise, as they increasingly utilized flexible pay-over-time options for everyday purchases,” the company said.

A Klarna spokesperson said, “While it’s not our place to tell people how to shop or where to buy, we do think it’s our role to give people choice, convenience and flexibility when it comes to paying for everyday purchases like groceries and household goods.”

Some analysts worry the growth and popularity of BNPL services could spur more risky spending.

Researchers at the New York Federal Reserve recently found BNPL customers use the services differently depending on their finances. Those on shakier footing tend to use them like credit cards “to make medium-size, out-of-budget purchases frequently,” they wrote. More financially stable users turn to BNPL less regularly but do so largely to avoid credit-card interest for big purchases.

It has been a great way to help me with money management.

Afterpay user Deijanae Duncan, 36

Deijanae Duncan, 36, said she first started using Afterpay for beauty and fashion purchases, and then for cruise tickets. More recently, she’s used it to buy glasses for herself and sports equipment for her three sons.

“It wasn’t like I was experiencing any financial hardship,” said Duncan, who lives in Los Angeles and works as a project manager for a federal agency. “It has been a great way to help me with money management.”

The New York Fed researchers said purchases under $250 were among the most common for both types of borrowers they examined. While financially stable customers were far more likely to use BNPL services for pricier purchases around the $2,000 mark, even low-dollar installment loans can add up, especially for users with many open at once.

Still, BNPL can be a responsible option, said Kevin King, vice president of credit risk and marketing strategy at LexisNexis Risk Solutions.

“In a lot of ways, we’d rather have people who are in a tough financial position financing essential goods with this than financing a $400 Nordstrom purchase, which has its time,” he said.

J.J. McCorvey is a business and economy reporter for NBC News.

Looking for a job in the Florida Keys? These positions can pay more than $80,000 a year

If you love to visit the Florida Keys, how would you like to work there?

Monroe County and Key West have lots of open government positions, many of which carry salaries of more than $80,000 a year.

Here’s a look at recent public sector job postings across the Keys:

Monroe County

The county career page lists the following jobs with salaries around $80,000 or more:

Assistance county attorney

Description: Responsibilities include providing legal analysis and advice to the Board of County Commissioners, the County’s Administrative Staff and various County-related agencies, boards, and committees.

Salary: $96,904.68 to $155,047.48

Location: Key West

Executive assistant fleet management

Description: Assists the director and business administrator of fleet management with administrative duties.

Salary: $52,025.15 to $80,638.98

Licensing coordinator

Description: Responsible for coordinating all aspects of contractor licensing as it relates to state and county requirements for permitting and construction in Monroe County.

Salary: $49,547.76 to $76,799.04

Location: Monroe County

Road technician

Description: Responsible for repair and maintenance to county roads, bridges, and rights-of-way using a variety of machines, tools, and equipment.

Location: Key Largo

Customer service representative

Description: Assists the staff and community with all aspects of permitting (intake, routing for plan review, issuance, and inspections)

Location: Stock Island, Big Pine Key, Marathon

Project manager

Description: Assists with administration and coordination of county projects from inception through completion, including supervision of staff, and inspection of projects which include reviewing documents and ensuring compliance with applicable laws and codes. Assists with preparing RFQs, RFPs, and Progress Status reports.

Salary: $81,363.04 to $130,180.86

Building inspector / plans examiner

Description: Responsible for inspecting structural and non-structural construction for conformance with plans, specifications, and applicable codes

Salary: $72,412.81 to $115,860.50

Location: Key Largo, Marathon

Systems analyst

Description: Responsible for advanced, higher-level help desk support to end-users over the telephone or in person in areas of special tasks and training for new users. Receives, configures, installs, and troubleshoots personal computer systems, printers, server applications, network switches, routers, and other electronic devices throughout Monroe County departments.

Salary: $68,313.97 to $109,302.35

Network engineer

Description: Responsible for network engineering, setup, configuration, installation, upgrades, advanced troubleshooting, and preventative/remedial maintenance for enterprise routing and switching environments, virtual private networking (VPN), firewalls, voice communications infrastructure/systems (including Voice Over IP), and wireless networking and monitoring systems.

The city career page lists the following jobs with salaries around $80,000 or more a year:

Administrator coordinator

Description: Secretarial, administrative position requiring confidentiality for the Community Services Department. . Provides administrative/secretarial support for the Tree Commission and the Bicycle/Pedestrian Coordinator, including preparation of documents, attends meetings, record minutes and permits.

Salary: $47,152 to $61,298

Electrician

Description: Performs skilled work involving new construction, general maintenance, and repair of city-owned buildings and facilities. Primary duties include maintenance and repair of electrical, control systems, lighting, heating, and air conditioning systems, replacing and repairing electrical plumbing components and electrical fixtures/wiring, generators, general facilities maintenance, and office renovation.

Salary: $69,245 to $90,018

Fleet foreman

Description: Responsible for overseeing all possible repair and maintenance of city-owned equipment and rolling stock. This includes planning, scheduling, and tracking supplies and equipment essential to the daily operations of a city-wide fleet service.

Salary: $61,523 to $ 79.980

Historic architectural preservationist

Description: Responsibilities include technical analysis of Certificate of Appropriateness applications, daily contact with the public regarding historic preservation and development matters that are proposed within the historic zoning districts and buildings, structures, and sites under the Historic Architectural Review Commission.

Salary: $65,270 to $84,851

Utilities director

Description: Responsible for the overall planning, organization, and management of all aspects of departmental functions, including general administration, budgeting, capital planning, rate models, and policy development.

Salary: $111,118

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