A client pays $100 on each doctor's visit before their insurance starts to pay. Which term describes this type of payment?

• A. Premium
• B. Coinsurance
• C. Deductible
• D. Reimbursement

Answer: (C)

At the heart of this is how much the patient must pay out of pocket before the insurance begins to contribute. A deductible is the amount the insured must pay before the plan starts sharing costs. So paying a fixed amount, like $100, for each visit before the insurance pays, describes funding that initial out-of-pocket portion until the deductible is met. After meeting the deductible, the plan typically covers costs according to its other cost-sharing rules (such as coinsurance or copays). This differs from a premium, which is the regular amount paid to maintain coverage regardless of services, from coinsurance, which is the percentage you pay after meeting the deductible, and from reimbursement, which is getting money back from the insurer for services received.