If a patient pays out-of-pocket for services after insurance coverage, this is referred to as:

• A. Cost sharing
• B. Premium
• C. Deductible
• D. Copayment

Answer: (A)

Cost sharing is the portion of medical costs that the patient pays out of pocket, after the insurer has contributed or as part of the plan’s cost-sharing structure. It encompasses the various ways patients share costs with their plan, including the amounts paid as deductibles, coinsurance, and copayments. In this scenario, once insurance has covered its portion, any remaining amount the patient pays out of pocket falls under cost sharing, making this the best descriptor. The other terms refer to more specific concepts: a premium is the ongoing amount paid to keep the policy; a deductible is the amount paid before the insurer starts paying; a copayment is a fixed fee paid at the time of service.