Which term refers to the share of the cost for a healthcare service not covered by health insurance?

Which term refers to the share of the cost for a healthcare service not covered by health insurance?

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

Answer: (C)

Copayment is the fixed amount you pay for a healthcare service at the time you receive it, with the rest of the cost covered by insurance. This amount represents the portion of the bill the patient is responsible for on that visit, separate from what the insurer pays. It’s a specific form of cost sharing per service. In contrast, a deductible is the amount you must pay before insurance starts paying, coinsurance is the percentage of costs after meeting the deductible, and out-of-pocket is the broader total you pay across a period that includes copays, deductibles, and coinsurance. LTSS refers to long-term services and supports and isn’t about cost sharing.

Copayment is the fixed amount you pay for a healthcare service at the time you receive it, with the rest of the cost covered by insurance. This amount represents the portion of the bill the patient is responsible for on that visit, separate from what the insurer pays. It’s a specific form of cost sharing per service. In contrast, a deductible is the amount you must pay before insurance starts paying, coinsurance is the percentage of costs after meeting the deductible, and out-of-pocket is the broader total you pay across a period that includes copays, deductibles, and coinsurance. LTSS refers to long-term services and supports and isn’t about cost sharing.