The financial responsibility amount before an insurance policy pays is known as what?

The financial responsibility amount that a patient must pay before their insurance policy begins to cover any expenses is referred to as a deductible. This is a critical concept in health insurance, as the deductible is the threshold that must be reached through out-of-pocket expenses before the insurance company starts to contribute to the cost of medical services.

Once an individual meets their deductible, the insurance plan may cover a percentage of the remaining costs, often subject to various other payment structures. The timing and amount of the deductible can vary widely between plans, determining how much a patient ultimately pays before receiving full benefits from their insurance.

In contrast, copayments are fixed fees paid by the insured for specific services, coinsurance is the percentage of costs the insured pays after meeting the deductible, and a fee schedule refers to the predetermined list of fees that an insurer will pay for specific services provided by healthcare providers. Understanding these terms is essential for managing health care expenses and navigating insurance coverage effectively.