In a health insurance context, what is a coinsurance or co-payment?

In a health insurance context, a coinsurance or co-payment refers to the portion an insured individual must pay for medical expenses. This cost-sharing mechanism is a way to balance the financial responsibilities between the policyholder and the insurance provider. When an insured person receives medical care, they are typically required to pay a certain percentage of the cost (in the case of coinsurance) or a fixed amount per visit or service (in the case of a co-payment). This not only helps manage the overall cost of healthcare by making individuals more conscious of their healthcare spending but also allows insurers to share the financial risk with their policyholders.

The other choices do not accurately define coinsurance or co-payment. The total premium refers to the regular amount paid for the insurance policy itself, which is separate from out-of-pocket expenses. The amount insurance covers is distinct from what the insured pays as coinsurance or co-payment, since it typically highlights the insurer's share rather than the individual's responsibility. Lastly, a deductible is the amount that an insured person must pay out-of-pocket before their insurance begins to cover any costs, which is a different concept altogether from coinsurance or co-payments.