Which of the following is an example of cost-sharing?

Cost-sharing refers to the way that costs are distributed between the insurer and the insured. It is a mechanism that allows both parties to have a financial stake in the health care services used. The annual deductible is a specific out-of-pocket amount that an insured individual must pay for covered healthcare services before the insurance plan starts to pay. This means that until the individual has paid this amount, they bear the full cost of their healthcare expenses, which directly reflects the concept of cost-sharing.

In contrast, a monthly insurance premium is a fixed payment made to maintain the insurance coverage but does not represent a share of costs incurred when utilizing services. Similarly, a lifetime maximum limit sets a cap on how much the insurer will pay over the lifetime of the policy, which is more about managing risk rather than sharing costs. A pre-existing condition clause relates to underwriting practices and limits coverage for conditions existing before the policy started but does not pertain to how costs are shared when care is received.

Thus, the annual deductible exemplifies cost-sharing as it creates a direct financial interaction between the insured and the insurance provider concerning healthcare expenses.