In plain English
This means the cost comes from the insured person's own funds. It is money the person pays themselves instead of the insurance company paying it or paying the person back.
In context
There, "out-of-pocket" labels the spending category for costs the insured person would pay from their own money rather than have paid or reimbursed by the insurance company.
- Situation
- Reading premium, deductible, excess, copay, limit, and out-of-pocket fields
- What it communicates
- labels the member-spending category in the cost estimator
Meaning limits
By itself, the term does not tell you the amount the person will pay.
Examples
“Because her plan would not reimburse the vaccine, the entire fee was an out-of-pocket expense.”
“The monthly statement grouped the injection and the follow-up visit under out-of-pocket costs.”