Co-insurance is best defined as what type of payment?

Prepare for the HSS LEAP A Test. Enhance your skills with flashcards and multiple-choice questions that include hints and explanations. Gear up for your assessment!

Co-insurance refers to a cost-sharing arrangement between the insurance provider and the policyholder, where after the deductible has been met, the patient is responsible for a certain percentage of the allowed costs for covered healthcare services. This means that for each medical service, the insurance company pays a specific percentage while the patient pays the remaining percentage.

For instance, if a patient has a co-insurance model of 20%, after fulfilling their deductible, the insurance may cover 80% of the costs for a medical service, leaving the patient to cover the remaining 20%. This structure incentivizes both the insurer and insured to manage healthcare expenses wisely, as the patient has a vested interest in understanding the costs involved.

Other potential answers do not accurately describe co-insurance. Fixed amounts for doctor visits pertain to co-pays, while annual limits pertain to maximum out-of-pocket expenses, and payment structures based on income levels generally relate to sliding scale fees rather than the co-insurance model.

Subscribe

Get the latest from Examzify

You can unsubscribe at any time. Read our privacy policy