What term refers to the percentage of service costs patients are responsible for after meeting their deductible?

Study for the FMC Insurance Coordinator Test. Prepare with comprehensive flashcards and multiple choice questions, detailed explanations provided for each. Ace your exam!

Coinsurance is the correct term that describes the percentage of service costs that patients must pay after they have met their deductible. In most health insurance plans, the deductible is the fixed amount that a patient must spend out-of-pocket before their insurance begins to cover costs. Once this threshold is reached, coinsurance comes into play, where the patient and the insurance company share the costs for covered services, typically expressed as a percentage, such as 80/20 or 70/30. For instance, if a patient has a coinsurance rate of 20%, this means they will pay 20% of the costs for a service, while the insurance covers the remaining 80%.

The other terms do not convey the same concept. A premium is the amount paid regularly to maintain insurance coverage, but it does not relate to cost-sharing after meeting the deductible. The deductible itself represents the initial out-of-pocket expense before insurance kicks in, and comprehensive coverage generally refers to a type of insurance that covers a wide range of services rather than a specific payment structure after deductibles. Understanding the role of coinsurance is key for patients to anticipate their ongoing healthcare costs beyond the initial deductible phase.

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