out-of-pocket
Referring to expenses for medical care that are not reimbursed by insurance and must be paid directly by the patient using their own cash.
This term can describe individual expenses (like a copay) or the 'out-of-pocket maximum,' which is the absolute limit a patient will have to pay in a year before insurance covers 100% of all medical costs.
Word relationships
- direct expense: Direct expense is a general accounting term, whereas out-of-pocket is the standard consumer and medical term for personal cash spending.
- reimbursed: Reimbursed expenses are those paid back to you by an insurer or employer, whereas out-of-pocket expenses are paid entirely by you.
Commonly confused with
- deductible: The deductible is a specific threshold of spending; out-of-pocket expenses include the deductible, copays, and coinsurance combined.
Collocations
- out-of-pocket maximum
- out-of-pocket expenses
- out-of-pocket costs
- pay out-of-pocket
Example sentences
- "Once you reach your annual out-of-pocket maximum, the insurance company will pay one hundred percent of your covered medical expenses for the rest of the year." An explanation of financial protection features.
- "He had to pay three hundred dollars out-of-pocket for the prescription because his insurance plan did not cover that specific brand." A warning about unexpected medical bills.
Memory hook
Imagine physically pulling money 'out of your pocket' and handing it to the doctor because your insurance company isn't holding the wallet for you. Out-of-pocket is money straight from your wallet.
When not to use
Do not use 'out-of-pocket' to describe a situation where you are physically reaching into your pocket to grab an item; it is strictly a financial metaphor.
Fun facts
- In the early 20th century, 'out of pocket' was also used as slang in journalism to mean 'unreachable' or 'away from the office,' a usage that still persists in corporate jargon today.
Related words
Explore more words
reimburse, reimbursement, outpatient, expense, excess, expenditure
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