What is a copayment?

A copayment is a fixed amount you pay each time you use a medical service covered by your policy. It's a way of sharing the cost between the insurer and you.

A practical example: If your plan has a €5 copayment for specialist appointments, every time you see a dermatologist, an orthopaedic surgeon or any other specialist you pay that €5 on the spot (on top of the monthly premium you already pay).

With a policy without copayments, once you've paid the monthly premium you use everything included at no extra cost.

Side by side

Aspect	With copayments	Without copayments
Monthly premium	Lower	Higher
Cost per appointment	Yes (€3-€20)	No
Cost per A&E visit	Yes (€10-€25)	No
Fixed monthly spend	No (varies with use)	Yes (always the same premium)
Predictability	Lower	Total
Barrier to access	Can put you off going	None
Good for occasional use	Yes	No (you'd pay more than you need)
Good for frequent use	No (copayments add up)	Yes

Advantages of copayment plans

A lower monthly premium

The main advantage is financial: by sharing part of the cost through copayments, the monthly premium comes down significantly. That puts private cover within reach of more people.

You pay for what you use

You only pay extra when you actually use a service. In months when you don't see a doctor, your spend is just the premium.

The same medical network

The same hospitals, clinics and specialists are available on plans with and without copayments.

Ideal for healthy people

If you're in good health and only see a doctor occasionally, the odd copayment will be negligible next to what you save on the premium.

Advantages of plans without copayments

Completely predictable spending

You know exactly what you'll pay each month. No surprises, no variable costs. That makes household budgeting far easier.

Nothing standing between you and the doctor

Copayments, even small ones, can act as a psychological brake on booking an appointment. Without them, you'll never hesitate, because it costs you nothing extra.

Bigger savings with frequent use

If you see doctors regularly, copayments add up. A plan without them puts a ceiling on your healthcare spending regardless of how often you use it.

Complete peace of mind

Knowing any medical need is covered at no extra cost has a value of its own, particularly where health is concerned.

When a copayment plan makes sense

You're young and healthy: You see a doctor 2-3 times a year at most.
Your budget is tight: Keeping the monthly premium low is the priority.
You use it as a top-up: You already have public healthcare and use private cover occasionally.
You're insuring just yourself: No children or dependants multiplying the visits.

When a plan without copayments makes sense

You see doctors often: More than 6-8 visits a year across appointments, tests and treatment.
You have young children: Children see the paediatrician a lot. With copayments, the spend multiplies.
You have a chronic condition: You need regular monitoring and periodic tests.
You value peace of mind: You don't want to think about money where your health is concerned.
You're over 50: With age, medical appointments tend to become more frequent.

Let's do the maths: two real examples

Example 1: A young, healthy person (28)

Sees a doctor 4 times a year (2 appointments + 1 blood test + 1 A&E visit).

Item	With copayments	Without copayments
Monthly premium	€40	€70
Estimated annual copayments	€30	€0
Total annual cost	€510	€840

Result: The copayment plan saves them €330 a year.

Example 2: A family with two children (adults aged 38)

The four of them see doctors 20 times a year (paediatrician, specialists, blood tests, A&E).

Item	With copayments	Without copayments
Monthly family premium	€130	€200
Estimated annual copayments	€140	€0
Total annual cost	€1,700	€2,400

Result: Although the no-copayment plan costs €700 more, the family avoids the mental arithmetic of tracking copayments and can go to the doctor whenever they need to without thinking twice. Every family decides for itself.

Note: these are simplified examples. Real prices depend on the specific plan and location.

The key: work out your total annual cost

Don't compare monthly premiums alone. The real cost of a policy is:

Total cost = (monthly premium × 12) + estimated annual copayments

If the result is similar between a plan with copayments and one without, choose the one that gives you more peace of mind. If there's a noticeable difference, ask yourself whether that difference justifies the convenience of having no copayments.

Frequently asked questions

Is there a cap on copayments? Some plans set an annual copayment limit, after which they stop charging. Not all plans offer it, so it's an important thing to check.

Are copayments paid at the appointment? It depends on the plan. Some charge on the spot; others add it to your monthly bill along with the premium.

Can I switch from a copayment plan to one without? Yes, you can normally change type at your policy's annual renewal.

Copayment or no copayment: which is better for you?

Find out which option suits you better