Certified Healthcare Access Associate (CHAA) Practice Test

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What is the definition of a deductible in the context of insurance?

The total cost of care before insurance pays

The amount a patient pays for a medical service

The amount the insurance company requires you to pay before insurance pays

In the context of insurance, a deductible is defined as the amount the insurance company requires you to pay before insurance benefits begin to kick in. For instance, if an insurance policy has a deductible of $1,000, the insured individual must pay that amount out-of-pocket for their medical expenses before the insurance provider will cover any additional costs. This concept is critical in understanding how insurance plans work, as it directly affects patient out-of-pocket costs and the financial relationship between policyholders and insurers.

The other options provided describe different aspects of healthcare costs but do not accurately define a deductible. For example, one option mentions the total cost of care before insurance pays, which does not specify that it is the insured individual’s responsibility to cover a part of that cost first. Another option refers to the amount a patient pays for a medical service, which can include co-pays or out-of-network charges, but not necessarily the deductible. Lastly, the mention of a fixed fee that patients pay regardless of insurance does not relate to the specific concept of a deductible, as that describes a co-payment structure instead.

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A fixed fee patients pay regardless of insurance

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