Which items are examples of patient cost-sharing in the given example?

Which items are examples of patient cost-sharing in the given example?

• A. Deductible and Copayment
• B. Premium and Deductible
• C. Copayment and Coinsurance
• D. Premium and Copayment

Answer: (A)

Patient cost-sharing is the portion of medical costs you pay out of pocket when you receive care, such as a deductible, copayment, or coinsurance. Premium, on the other hand, is the fixed amount you pay periodically to maintain insurance, regardless of services used. In the given example, the items that represent cost-sharing are the deductible and the copayment. The deductible is the amount you must pay before the plan begins to pay, and the copayment is a fixed amount due at the time of service for a specific visit or service. Premium does not count as cost-sharing because it’s paid to keep coverage active, not for a particular service. Coinsurance is another form of cost-sharing, but it’s not paired with deductible in this option.

Patient cost-sharing is the portion of medical costs you pay out of pocket when you receive care, such as a deductible, copayment, or coinsurance. Premium, on the other hand, is the fixed amount you pay periodically to maintain insurance, regardless of services used.

In the given example, the items that represent cost-sharing are the deductible and the copayment. The deductible is the amount you must pay before the plan begins to pay, and the copayment is a fixed amount due at the time of service for a specific visit or service. Premium does not count as cost-sharing because it’s paid to keep coverage active, not for a particular service. Coinsurance is another form of cost-sharing, but it’s not paired with deductible in this option.