Which is a fixed dollar amount that must be paid by the insured for charges of providers once a year in addition to the premium?

Which is a fixed dollar amount that must be paid by the insured for charges of providers once a year in addition to the premium?

• A. Coinsurance
• B. Primary Insurance
• C. Medicaid
• D. Deductible

Answer: (D)

The fixed amount described is the deductible. It’s the set dollar amount you must pay out of pocket each year for covered medical services before your insurance starts to pay benefits. It’s separate from your monthly premium—the premium is paid to keep the policy active, while the deductible is a payment you must meet before cost-sharing with the insurer begins. Once you’ve met the deductible, the plan typically pays more of the costs, often through coinsurance or copays. Coinsurance, in contrast, is the percentage you pay after meeting the deductible; primary insurance is simply the main payer, and Medicaid is a government program, not a per-year out-of-pocket amount.

The fixed amount described is the deductible. It’s the set dollar amount you must pay out of pocket each year for covered medical services before your insurance starts to pay benefits. It’s separate from your monthly premium—the premium is paid to keep the policy active, while the deductible is a payment you must meet before cost-sharing with the insurer begins. Once you’ve met the deductible, the plan typically pays more of the costs, often through coinsurance or copays. Coinsurance, in contrast, is the percentage you pay after meeting the deductible; primary insurance is simply the main payer, and Medicaid is a government program, not a per-year out-of-pocket amount.