Which term describes a fixed fee paid at the time of service, before insurance applies?

• A. Coinsurance
• B. Deductible
• C. Premium
• D. Copayment

Answer: (D)

This centers on the amount a patient pays directly at the time of a visit. A fixed amount due upfront is known as a copayment. It’s a set dollar amount you pay when you receive a service, and you pay it before the insurer processes or applies any benefits for that visit. For example, you might pay a $25 copayment for a routine office visit, regardless of the actual cost of the visit.

By contrast, the deductible is the total out-of-pocket amount you must spend before your insurance starts paying for most services in a policy year. Coinsurance is the portion of costs you pay after the deductible is met, usually a percentage. A premium is the regular, typically monthly, payment to maintain your insurance coverage, not tied to a single visit.