Coinsurance represents what aspect of healthcare costs?

Prepare for the Medical Assistant (MA) Administrative Assisting Test with interactive flashcards and multiple choice questions. Each question includes helpful hints and explanations. Ace your exam with confidence!

Coinsurance is a cost-sharing arrangement in health insurance that requires the insured to pay a specified percentage of covered healthcare expenses after they have met their deductible. This means that once the deductible, which is the amount patients must pay out-of-pocket for healthcare services before their health insurance begins to pay, has been satisfied, the coinsurance kicks in. For instance, if a patient has a coinsurance rate of 20%, they will be responsible for paying 20% of the costs of any covered medical services after the deductible is met, while the insurance company covers the remaining 80%.

The other options do not accurately define coinsurance. The total fee for a medical procedure relates to the overall billing of that procedure, which is not specific to how costs are shared between the patient and the insurer. The fixed cost for a primary care visit refers to copayment or copay, which is a predetermined amount a patient pays for a specific service rather than a percentage of the costs. The out-of-pocket maximum is the limit on the total amount a patient has to pay in a year for covered services; this is a separate concept from coinsurance.

Subscribe

Get the latest from Examzify

You can unsubscribe at any time. Read our privacy policy