Which term describes the amount insurance will pay for a covered service?

Prepare for the APTA Physical Therapy Test. Utilize multiple choice questions with hints and answers. Achieve excellence in your exam!

Understanding what the insurer will reimburse for a covered service hinges on the amount the plan recognizes as payable. This is the eligible expense—the portion of the charge that the plan will consider for reimbursement under the contract, subject to coverage rules and network status. Copayment is a fixed amount you pay at the time of service, coinsurance is the percentage you pay of the allowed amount after meeting the deductible, and the deductible is the initial amount you must pay out of pocket before the insurer contributes. So, the eligible expense is the amount the insurance will pay toward a covered service under the plan.