What term refers to the out-of-pocket expense the insured must pay before the insurer will cover the remaining costs?

The term that refers to the out-of-pocket expense that the insured must pay before the insurer begins to cover the remaining costs is called a deductible. This is a specific amount set within an insurance policy that the insured is responsible for paying for healthcare services before the insurance company will start contributing. For example, if a health insurance policy has a deductible of $1,000, the insured must pay that amount in healthcare costs before the insurer starts to share the costs of additional medical expenses.

The deductible is designed to encourage individuals to engage with their healthcare costs, helping to reduce unnecessary claims and ultimately keeping premiums lower. Once the deductible is met, the insurer typically covers a percentage of the remaining costs, with the insured possibly being responsible for coinsurance amounts or copayments for specific services.