What is the term for the benefits paid by a health insurance plan after a deductible is met?

What is the term for the benefits paid by a health insurance plan after a deductible is met?

• A. Premium benefits
• B. Deductible benefits
• C. Co-insurance benefits
• D. Co-payment benefits

Answer: (D)

The correct term for the benefits paid by a health insurance plan after a deductible is met is co-insurance benefits. Co-insurance refers to the percentage of costs that the insured must pay after the deductible has been satisfied. Once the deductible, which is the amount you pay out-of-pocket for healthcare services before your insurer begins to pay, has been met, the insurance plan usually specifies that the insurer will cover a certain percentage of the subsequent claims (referred to as co-insurance). For example, if after meeting the deductible the plan covers 80% of the costs, the insured then is responsible for the remaining 20%. This structure is designed to share the costs between the insurance company and the insured, ensuring that the insured has a stake in their healthcare spending. In contrast, premiums are the regular payments made to maintain the policy, and co-payments are fixed amounts paid for specific services or prescriptions at the time of receiving care, which do not relate directly to meeting deductibles. Therefore, co-insurance specifically addresses the shared costs after a deductible has been finalized, making it the appropriate term in this context.

The correct term for the benefits paid by a health insurance plan after a deductible is met is co-insurance benefits. Co-insurance refers to the percentage of costs that the insured must pay after the deductible has been satisfied.

Once the deductible, which is the amount you pay out-of-pocket for healthcare services before your insurer begins to pay, has been met, the insurance plan usually specifies that the insurer will cover a certain percentage of the subsequent claims (referred to as co-insurance). For example, if after meeting the deductible the plan covers 80% of the costs, the insured then is responsible for the remaining 20%. This structure is designed to share the costs between the insurance company and the insured, ensuring that the insured has a stake in their healthcare spending.

In contrast, premiums are the regular payments made to maintain the policy, and co-payments are fixed amounts paid for specific services or prescriptions at the time of receiving care, which do not relate directly to meeting deductibles. Therefore, co-insurance specifically addresses the shared costs after a deductible has been finalized, making it the appropriate term in this context.