Cost sharing, when you first hear it, might sound like a good thing. Something to help lessen the burden of costs you’re being socked with for your health insurance. Unfortunately, cost sharing in the United States often ends up to the detriment of the consumer, as health insurance companies raise their rates and have to ask consumers to pay a higher portion of what services cost. Sometimes insurance companies have to raise the rates for employers, who then have to turn around and raise the co-pays for their employers. It’s a vicious cycle, but other countries around the world have developed models to help lower and limit cost sharing that falls on the shoulder of consumers, and the United States might do very well to look into these models and implement them here. Especially with things as they are in our current economy, anything that can be done to keep hitting already weighed-down consumers with more costs should be a high priority.

What Exactly IS Cost Sharing in Health Insurance?

There are a few key specific points to understand when looking at the role cost sharing plays in health insurance. Direct forms of cost sharing between consumers and health insurance providers are things like the following: co-payments (what you pay per service), coinsurance (a percentage of the charge that you have to pay) and deductibles (the amount you have to pay out of your own pocket before coverage begins. This can be on all services or you can have a certain deductible on a type of procedure). Indirect cost sharing isn’t typically included in the standard definition of cost sharing in insurance, but they still cost consumers money and come right out of your pocket. These can be things like: charges when you go to see an out-of-network doctor, going to a specialist before seeing a primary care physician and being charged full price for that, any health services not covered by your insurance plan and health care premiums.

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