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Out-of-pocket expenses

Out-of-pocket expenses

Out-of-pocket expenses is an umbrella term for all healthcare expenses paid for by the individual rather than the insurer over the course of the plan year. They include deductibles, copayments and coinsurance but not monthly premiums.

The Affordable Care Act placed limits on out-of-pocket expenses (although generally this only refers to medical expenses covered by your plan and does not include out-of-network care). The limits for out-of-pocket expenses on plans for 2022 are $8,700 for an individual and $17,400 for a family.

Related Terms:

Coinsurance

Copayment / copays

Deductibles

Out-of-pocket maximum

Premiums

 

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