The physician bills $500 to a patient; the claim is denied by insurance, and the patient still owes $500 for the year. This amount is called what?

• A. Copayment
• B. Deductible
• C. Premium
• D. Coinsurance

Answer: (B)

Deductible is the portion of medical costs the patient must pay out of pocket before the insurer starts to share in the expenses for covered services within the policy year. It resets annually. In the scenario, the patient owes $500 for the year because that amount represents the deductible still unpaid; until the deductible is met, the patient is responsible for full allowed charges like this $500. A copayment is a fixed fee per visit, not tied to meeting an annual amount. A premium is the regular payment to maintain the policy, not a per-service amount. Coinsurance is the percentage of costs the patient pays after the deductible has been met.