What it means
Copays are predictable: the amount stays the same no matter what the plan pays the pharmacy. Your plan's drug list, or formulary, usually assigns a copay to each tier, with generics on the lowest tier and brand-name drugs higher.
Depending on the plan, the copay may apply right away or only after you meet your deductible. Some plans use copays for some tiers and coinsurance for others, so check the tier for your specific drug.
Copays generally count toward your out-of-pocket maximum. Once you reach it, covered in-network care is paid in full for the rest of the plan year.
Manufacturer copay or savings cards can lower a brand-name copay for people with commercial insurance. Federal rules generally keep them from being used with Medicare, Medicaid and other government plans, and the card terms can change at any time.
Why it matters
Your copay is the number that decides whether a covered GLP-1 is affordable month to month.