Which of the following terms defines the portion of costs the insured must cover?

Which of the following terms defines the portion of costs the insured must cover?

• A. Cost sharing
• B. Capitation
• C. Enrollment
• D. Coverage

Answer: (A)

Cost sharing is the portion of medical costs the insured pays out of pocket. It includes deductibles, copayments, and coinsurance, and it continues until the insured reaches the plan’s out-of-pocket maximum. This concept describes how, even with insurance, the patient must share in the cost of care to some extent. Capitation refers to a fixed payment to a provider per patient, enrollment is the process of joining a plan, and coverage is the protection the plan offers. So, the term that defines the insured’s share of costs is cost sharing.

Cost sharing is the portion of medical costs the insured pays out of pocket. It includes deductibles, copayments, and coinsurance, and it continues until the insured reaches the plan’s out-of-pocket maximum. This concept describes how, even with insurance, the patient must share in the cost of care to some extent. Capitation refers to a fixed payment to a provider per patient, enrollment is the process of joining a plan, and coverage is the protection the plan offers. So, the term that defines the insured’s share of costs is cost sharing.