Accident & Health FundamentalsQuestion 23 of 716
A health plan that requires the member to pay $30 every time they visit their primary care doctor is using which cost-sharing tool?
a.Out-of-pocket maximum
b.Copayment
c.Coinsurance
d.Deductible
Explanation
A copayment (copay) is a fixed dollar amount the member pays at the time of service, regardless of total charges. Deductibles are paid before benefits begin, coinsurance is a percentage share after the deductible, and the out-of-pocket maximum is the annual cap on cost-sharing.
Law Reference: Cost-sharing definitions – copaymentThis topic, taught in full in the California Life & Health Insurance Producer Exam guide. California Life & Health Insurance Producer Exam — Complete Study Guide (2026) — PDF + EPUB, $19.99 · 14-day refund →
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