A copayment, often referred to as a "copay," is a fixed, predetermined amount that an individual pays out-of-pocket for specific healthcare services after they have paid their deductible. Copayments are more common with managed care plans, such as HMOs, and can vary for different services within the same plan, like drugs, lab tests, and visits to specialists. Plans with lower monthly premiums usually have higher copayments, while plans with higher monthly premiums usually have lower copayments. Copayments are usually the responsibility of the policyholder. Copayments typically count towards the deductible in most health insurance plans, and once the deductible is met, the insurance coverage may change, such as transitioning to coinsurance, where the policyholder pays a percentage of the cost of covered services rather than a fixed copayment.