Georgia Navigator Practice Exam

Which term describes funds paid by the insured for all health care costs other than the premium?

1. Copayment

2. Cost-sharing

3. Deductible

4. Out-of-pocket limit

The correct answer is: Cost-sharing

The term that describes funds paid by the insured for all health care costs other than the premium is cost-sharing. Cost-sharing refers to the expenses that health insurance policyholders must pay out of their own pocket for covered health care services. This includes various forms of payments such as copayments, deductibles, and coinsurance. Copayments are specific fixed amounts that the insured pays for certain services. Deductibles are the amounts that must be paid out-of-pocket before the insurance coverage starts to pay its share. The out-of-pocket limit is the maximum amount that a policyholder will have to pay in a year, after which the insurance covers 100% of the costs. Understanding cost-sharing is crucial as it directly affects how much individuals pay for their health care and influences their overall health care costs. It is a key concept in health insurance, emphasizing the shared financial responsibility between the insurer and the insured.