Copagos

Copago, or copagos, refers to the portion of health-care costs that a patient pays at the point of service, with the remainder covered by a public or private insurer. Copagos are common in health systems that combine public funding with user contributions and can apply to medical consultations, diagnostic tests, procedures, and prescription medicines. They can take the form of a fixed fee per service, a percentage of the cost, or a mix of both, and may vary by service type, patient age, income, or disability status. Many systems also implement annual caps on total copagos or provide exemptions for certain groups.

The rationale behind copagos includes sharing the financial burden of care, discouraging unnecessary or excessive use of services, and generating revenue to sustain health services. Proponents argue that well-designed copagos can promote prudent use and help control public expenditures. Critics contend that copagos can create barriers to access, particularly for low-income individuals, the elderly, or those with chronic illnesses, potentially affecting treatment adherence and health outcomes. The impact of copagos depends on their level, the breadth of exemptions, and the presence of safety nets such as waivers, caps, or income-based thresholds.

Across jurisdictions, copagos vary widely in structure and generosity. Some systems impose higher copagos for elective services while protecting access to essential care, medicines, or preventive services through exemptions or reduced rates. Others apply uniform charges with broader safety nets. Copagos are a policy tool aimed at balancing equitable access with sustainable financing, but require careful design to minimize adverse effects on health equity and timely care.