Copayment and reimbursement in health insurance


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Copayment and reimbursement in health insurance

More and more people take out health insurance. Some of the aspects to take into account when looking for the medical policy that best suits our needs are the copayment and reimbursement, but what exactly are they and what is the difference?
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Table of Contents:

There are different types of health insurance today that, as a general rule, can be divided into two groups: health insurance with or without copayment and health insurance with reimbursement. Although the copayment and reimbursement refer to the payment of health services, in this article we will show you their definitions and the differences between copayment and reimbursement that you must take into account when contracting the policy that best suits your needs. Continue reading!

What is a medical reimbursement?

The reimbursement in health insurance is a modality by which the insurer offers the client a free choice product, in which the insured decides who he wants to treat him and in which medical center, regardless of the clinical picture and the medical network (own and / or contracted) offered by the insurer. In addition, with the advantage of being able to be attended anywhere in the world.

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Health Insurance that fit your needs

What is a copayment?

It is a small amount of money that you will have to pay when using a medical service and that helps reduce the cost of your health insurance.

Differences between policies with Copayment and Reimbursement

  • The first and most important difference derives from the definition of these two types of insurance. The health insurance with copay It includes certain guarantees for which the customer must pay a small amount to access them. While, on the contrary, the reimbursement medical insurance returns to the insured a percentage of the medical expenses established in the general and specific conditions of the policy.
  • Health insurance that includes a copayment system usually has a cheaper premium than reimbursement insurance, which, due to its flexibility, entails a higher annual payment.
  • The medical chart of health insurance with co-payment usually restricts the access to specialists located within the national territory, however, the reimbursement medical insurance allows you to go to specialists from all over the world, depending on the product contracted. 
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Plans that adapt to your needs
  • One of the advantages that you will find in co-pay medical insurance is that there is no established limit regarding the maximum amount per medical expenses, which does exist in the conditions of reimbursement medical insurance.
  • One of the 5 differences between copayment and reimbursement in terms of the specialists that you can access with each type of health insurance, is that insurance with copayment restricts the professionals you can go to in case of need to your medical chart. while with reimbursement medical insurance, you can go to any specialist.

In this way, knowing these 5 differences between copay and reimbursement You can choose a medical insurance according to the guarantees that best suit your circumstances, the final premium that you are willing to pay and the specialist doctors you want to access.

BMI has great options and benefits that adapt to your needs, just make a personalized consultation Contact us!

Phone number: (305) 443- 2898, Email:, or through our digital platforms such as, Instagram: @bmicompanies /Facebook: BMI Companies /LinkedIn: BMI Companies /Our website:

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