Which term describes the dollar amount paid out of pocket for healthcare services before health insurance covers the cost?

Which term describes the dollar amount paid out of pocket for healthcare services before health insurance covers the cost?

• A. Copayments
• B. Deductible
• C. Out-of-pocket
• D. HCBS

Answer: (B)

The upfront amount you must pay before insurance begins sharing costs is the deductible. This means you cover all eligible expenses out of pocket until you reach that set dollar amount, after which the plan starts paying according to its rules (often with coinsurance or copayments). Copayments are fixed fees per service regardless of the total cost, and the out-of-pocket maximum is the total limit you must pay in a year. HCBS is unrelated to this payment structure. So, the deductible best fits as the term described.

The upfront amount you must pay before insurance begins sharing costs is the deductible. This means you cover all eligible expenses out of pocket until you reach that set dollar amount, after which the plan starts paying according to its rules (often with coinsurance or copayments). Copayments are fixed fees per service regardless of the total cost, and the out-of-pocket maximum is the total limit you must pay in a year. HCBS is unrelated to this payment structure. So, the deductible best fits as the term described.