Cost Sharing in the United States

Introduction to Cost-Sharing (State statute topic)

The purpose of Cost Sharing is to provide a broad appreciation of the Cost Sharing legal topic. Select from the list of U.S. legal topics for information (other than Cost Sharing).

Concept of Cost-sharing in Health Insurance Law

In this context, the following is a definition of Cost-sharing: Health care provider charges for which a patient is responsible under the terms of a health plan. Common forms of cost-sharing include deductibles, coinsurance and co-payments. Balance-billed charges from out-of-network physicians are not considered cost-sharing. PPACA prohibits total cost-sharing exceed $5,950 for an individual and $11,900 for a family. These amounts will be adjusted annually to reflect the growth of premiums.

Cost Sharing in Health Care Law

A definition of Cost Sharing is available here: You may be required to pay a portion of the costs of your care. Examples of these costs include Co-payments, Co-insurance and annual Deductibles. The Affordable Care Act provides reduced cost sharing to eligible individuals and families based upon income.

Cost Sharing

In Legislation

Cost Sharing in the U.S. Code: Title 33, Chapter 36, Subchapter I

The current, permanent, in-force federal laws regulating cost sharing are compiled in the United States Code under Title 33, Chapter 36, Subchapter I. It constitutes “prima facie” evidence of statutes relating to Navigation and Navigable Waters (including cost sharing) of the United States. The reader can further narrow his/her legal research of the general topic (in this case, Water Resources Development and Waters of the US Code, including cost sharing) by chapter and subchapter.

Resources

Further Reading

• Information about Cost Sharing in the Gale Encyclopedia of American Law.