out-of-pocket costs


Also found in: Dictionary, Financial.
Related to out-of-pocket costs: Opportunity costs, Sunk costs

out-of-pocket costs

Managed care Health care costs that a covered person must pay out of pocket–eg, coinsurance, deductibles, etc. See Copayment.

co·pay·ment

, copay (kōpā-mĕnt, kōpā)
A fixed or set amount paid for each health care or medical service; the remainder is paid by the health insurance plan. In common parlance, copay is the term used.
See also: coinsurance, cost sharing
Synonym(s): out-of-pocket costs, out-of-pocket expenses.
References in periodicals archive ?
Australians pay some of the highest out-of-pocket costs in the world.
Employees picking up a larger cost share results from a trade-off of lower health insurance premiums for higher deductibles and out-of-pocket costs.
Dispute was born as a result of its founder's personal experience, who watched as a family member faced more than $40,000 of out-of-pocket costs following a sudden heart attack and subsequent surgery.
EXTREMELY OR VERY SATISFIED WITH OUT-OF-POCKET COSTS TRADITIONAL PLAN 44% CDHP 31% HDHP 20%
Out-of-pocket costs include a health plan's annual deductible, which is the amount before insurance starts paying, as well as any copayments and cost-sharing.
Deciding on a metal level is the first step in understanding which plan may be right for you You also will want to understand how your plan's benefits are designed so that you strike the balance between coverage that meets your health care needs and the amount you are willing to pay in premiums and out-of-pocket costs All plans within a single metal level are not the same, and depending on your particular health needs and the prescription medications you take, the amount you pay out-of-pocket each year could vary significantly within the same metal level See the Key Components of Plan Selection section for a guide to choosing among plans in a given level of coverage.
For such beneficiaries who use a given specialty tier-eligible drug, different cost-sharing structures result in varying out-of-pocket costs only until they reach the catastrophic coverage threshold, which 31 percent of these beneficiaries did in 2007.
First, the decision to initiate therapy with these drugs is somewhat, but not highly, responsive to patient out-of-pocket costs.
Tracking out-of-pocket costs is necessary to determine when each beneficiary has reached the required spending threshold at which Medicare's catastrophic drug coverage starts.
The health care providers have been inappropriately waiving the out-of-pocket costs for medical services provided to state and local government employees, DiNapoli said.
According to a recent study, consumer-driven health plans (high-deductible plans combined with a savings account) generally require women to pay higher out-of-pocket costs for maternity care than do traditional insurance plans.
The following table shows the computation of the net out-of-pocket costs of using the current combine over the next five years until John's retirement.