The balance the policyholder must pay the provider is called what?

The balance the policyholder must pay the provider is called what?

• A. Cost sharing
• B. Premium
• C. Copayment
• D. Deductible

Answer: (A)

In health insurance, the out-of-pocket amount the insured pays for services is called cost sharing. This is the portion of the bill that the patient is responsible for after the insurer covers its share. Cost sharing includes several components such as copayments (a fixed amount per visit or service), deductibles (the amount you must pay before the insurer starts paying), and coinsurance (a percentage of costs after the deductible). So the “balance” the policyholder must pay to the provider falls under cost sharing—the overall share of costs the patient is responsible for, not the premium paid to maintain coverage. The other terms don’t fit as the general concept: a premium is the periodic payment for coverage, while copayment and deductible are specific parts of cost sharing.

In health insurance, the out-of-pocket amount the insured pays for services is called cost sharing. This is the portion of the bill that the patient is responsible for after the insurer covers its share. Cost sharing includes several components such as copayments (a fixed amount per visit or service), deductibles (the amount you must pay before the insurer starts paying), and coinsurance (a percentage of costs after the deductible). So the “balance” the policyholder must pay to the provider falls under cost sharing—the overall share of costs the patient is responsible for, not the premium paid to maintain coverage. The other terms don’t fit as the general concept: a premium is the periodic payment for coverage, while copayment and deductible are specific parts of cost sharing.