Which of the following refers to a portion of an insured's medical costs they are responsible for after the deductible is met?

Prepare for the Georgia Health Insurance Exam. Study using flashcards, multiple-choice questions, and get ready with explanations for each question. Ace your exam!

The correct choice, which refers to a portion of an insured's medical costs they are responsible for after the deductible is met, is coinsurance. Coinsurance is a type of cost-sharing agreement where the insured pays a specific percentage of the medical expenses after they have satisfied their deductible. For example, if a health insurance plan has a coinsurance rate of 20%, after the insured meets their deductible, they would pay 20% of the covered medical costs, while the insurance company covers the remaining 80%.

This arrangement encourages insured individuals to share the costs of their healthcare and can help insurance companies manage risk and costs. It differs from a copayment, which is a fixed amount the insured pays at the time of service regardless of the total cost of the service. The out-of-pocket maximum is the limit on what the insured would pay in a year; once this threshold is reached, the insurance would typically cover 100% of additional costs. A coverage limit is the maximum amount an insurer will pay for a covered service. Understanding these terms is essential for navigating health insurance policies effectively.

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