Certified Application Counselor Practice Test

What scenario best describes the function of a deductible?

1. It is paid monthly regardless of service received

2. It must be met before insurance starts covering costs

3. It varies based on the service provided

4. It is a one-time fee for enrollment only

The correct answer is: It must be met before insurance starts covering costs

The scenario that best describes the function of a deductible is when it must be met before insurance starts covering costs. A deductible is a specified amount that a policyholder must pay out-of-pocket before their health insurance begins to pay for covered services. For instance, if a plan has a deductible of $1,000, the policyholder would need to incur $1,000 in eligible medical expenses before the insurance coverage kicks in. This structure is important as it helps ensure that policyholders share in the cost of their healthcare, which can promote more mindful healthcare consumption. The other options do not accurately reflect the role of a deductible. Payments made monthly represent premiums, not deductibles, and while deductibles can vary from one insurance plan to another, they are not typically dependent on the specific services received. Lastly, stating that a deductible is a one-time fee for enrollment conflates it with other types of fees associated with insurance, rather than its actual function in the cost-sharing process during medical care.