What term refers to the percentage of a health care bill that an insured individual must pay before their insurance pays?

The term that best reflects the percentage of a health care bill that an insured individual must pay before their insurance starts to cover costs is "deductible." The deductible is a fixed amount that a policyholder must pay out-of-pocket for health care services before the insurance plan begins to share the costs. For example, if a health plan has a deductible of $1,000, the insured must pay the full amount of their medical expenses up to this threshold before the insurance coverage kicks in.

On the other hand, coinsurance refers to the percentage of costs that the insured is required to pay after they have met their deductible. For instance, if a person has a coinsurance rate of 20%, they would pay 20% of the costs for a service after meeting the deductible. Copayment is a predetermined fixed fee that the insured pays for specific services, such as a doctor's visit or a prescription, while the premium is the monthly or annual fee paid to maintain the insurance coverage, regardless of whether care is received. Understanding these terms is crucial for navigating health insurance policies effectively.