Which term describes when a plan pays 70% of the allowed amount and the patient pays 30%?

Which term describes when a plan pays 70% of the allowed amount and the patient pays 30%?

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

Answer: (A)

Coinsurance is the shared payment arrangement where the plan covers a percentage of the allowed amount and the patient covers the remainder. When the plan pays 70% and the patient pays 30%, that split describes coinsurance. For example, if the allowed amount is $100, the plan would pay $70 and the patient would owe $30. Copayment is a fixed dollar amount per visit, not a percentage. A deductible is the amount you must pay before the plan starts paying. A premium is the regular payment you make to maintain coverage.

Coinsurance is the shared payment arrangement where the plan covers a percentage of the allowed amount and the patient covers the remainder. When the plan pays 70% and the patient pays 30%, that split describes coinsurance. For example, if the allowed amount is $100, the plan would pay $70 and the patient would owe $30. Copayment is a fixed dollar amount per visit, not a percentage. A deductible is the amount you must pay before the plan starts paying. A premium is the regular payment you make to maintain coverage.