Which term describes the amount that must be paid by the patient before insurance benefits are valid?

The correct term that describes the amount that must be paid by the patient before insurance benefits are valid is "deductible." A deductible is the fixed amount that an insured individual must pay out-of-pocket for healthcare services before their insurance plan starts to pay for covered expenses. Once the deductible is met through qualified medical expenses, the insurance company begins to cover its share according to the policy terms.

In contrast, other terms like co-payment refer to a set fee that a patient pays for specific services at the time of the visit, like a doctor’s appointment. The policy limit defines the maximum amount an insurance company will pay for covered services over a specific period or per event, and the premium is the regular payment made to maintain the insurance policy itself, not directly tied to out-of-pocket expenses for care. Understanding these distinctions is critical for grasping how health insurance plans work in relation to patient costs.