Difference between revisions of "Out-of-pocket"
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| − | Out-of-pocket or OOP is the amount of the health plan member pays for covered services. An out-of-pocket expense is an expense to the health plan member. | + | Out-of-pocket or OOP is the amount of the [[health plan member]] pays for covered services. An out-of-pocket expense is an expense to the health plan member. |
| − | Out-of-pocket expenses usually include [[deductible|deductibles]], [[ | + | Out-of-pocket expenses usually include [[deductible|deductibles]], [[coinsurance]], [[copayment|co-payments]], pharmacy costs, and any additional costs due to lab visits. |
| − | + | [[Health insurance plan|Health insurance plans]] will usually define the [[out-of-pocket maximum]] or out-of-pocket limit which is the most a health plan member will have to pay for covered services in a plan year. After spending this amount on deductibles, copayments, and coinsurance, the health plan pays 100% of the costs of covered benefits. | |
Latest revision as of 05:35, 24 February 2017
What is out-of-pocket?
Out-of-pocket or OOP is the amount of the health plan member pays for covered services. An out-of-pocket expense is an expense to the health plan member.
Out-of-pocket expenses usually include deductibles, coinsurance, co-payments, pharmacy costs, and any additional costs due to lab visits.
Health insurance plans will usually define the out-of-pocket maximum or out-of-pocket limit which is the most a health plan member will have to pay for covered services in a plan year. After spending this amount on deductibles, copayments, and coinsurance, the health plan pays 100% of the costs of covered benefits.
