Which of the following terms refers to the percentage of costs the insured has to pay after meeting the deductible?

Prepare for the Florida 2-40 Health Insurance License Exam. Utilize flashcards, multiple-choice questions with hints, and detailed explanations. ACE your test!

The correct term that refers to the percentage of costs the insured has to pay after meeting the deductible is co-insurance. In health insurance, co-insurance is a cost-sharing arrangement where the insured pays a specified percentage of the covered healthcare expenses, while the insurer pays the remaining percentage.

For example, if a health insurance policy has a co-insurance clause of 20%, after the insured has met their deductible, they would pay 20% of the costs for covered services, and the insurance company would cover the remaining 80%. This mechanism helps to share the financial burden between the insurer and the insured, encouraging responsible use of medical services while allowing for lower premiums.

Understanding co-insurance is crucial for budgeting healthcare expenses and determining overall out-of-pocket costs. The other terms present, such as copayment, refer to a fixed amount paid for a service (like a doctor's visit), and the out-of-pocket maximum is the limit on the total amount an insured pays in a policy period. Fixed payment, on the other hand, is not a standard insurance term used in this context and does not apply to the arrangement of sharing costs post-deductible.

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