Question

your health insurance copay is
paid by the insurer
applied on an annual basis
a fixed amount of money you pay each time you use your plan
amount paid out of pocket before your insurance coverage

Explanation:

A health insurance copay is a fixed, out-of-pocket amount the insured pays for a covered service at the time of use, separate from the insurer's contribution, annual deductibles, or out-of-pocket maximums.

Answer:

A fixed amount of money you pay each time you use your plan