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Cost-Sharing Definition


Cost-Sharing Definition: Any contribution consumers make towards the cost of their healthcare as defined in their health insurance policy.

Two types of cost-sharing commonly used in subsidized insurance programs are:

  • Set fee paid by the consumer "up-front," such as sliding scale premiums or enrollment fees.
  • Set fee paid by the consumer "at-time-of-service," such as copayments or deductibles, in order to obtain specific healthcare services (e.g., office visit or prescription drugs).
Another form of cost-sharing commonly found in private insurance policies (and less often utilized in public programs is coinsurance. Coinsurance is a percentage of the total charges incurred for medical services.

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