Texas A&M University (TAMU) PHLT313 Health Care and Public Health System Exam 2 Practice

Cost sharing refers to the practice of dividing the costs of healthcare services between the insurer and the insured. This typically includes different mechanisms like premiums, deductibles, and copayments, which are all designed to share the financial burden of healthcare expenses.

Premium cost sharing occurs when the insurer and the insured share the cost of an insurance premium. This is a common practice in many employer-sponsored health insurance plans.

Deductibles are the amounts that an insured individual must pay out-of-pocket for healthcare services before the insurance starts to pay. This directs some level of cost responsibility to the insured, encouraging individuals to be mindful of healthcare utilization.

Copayments, often simply referred to as copays, are fixed amounts that an insured individual pays for specific services at the time of care, with the insurance covering the remaining balance. This also encourages more informed decision-making about healthcare use, as individuals have to consider out-of-pocket costs.

Referral fees, on the other hand, typically pertain to payments made for directing patients to certain providers or services, and are not a systematic form of cost-sharing in health plans. They do not reflect the shared financial responsibility associated with typical insurance mechanisms; therefore, they do not fit within the definitions of cost sharing like the other options do