Out-of-Pocket Costs (Health Care) Law and Legal Definition

Out-of-pocket costs are costs paid by a beneficiary from his/her pocket for the health care received, in spite of the insurance coverage and the monthly premium paid by the beneficiary. The out of pocket costs may or may not be reimbursed. It is the amount that the health insurance company wants a beneficiary to pay towards the cost of health related services. It may include an annual deductable, coinsurance, and copayments for doctor visits and prescription drugs, depending upon the health plan of the beneficiary.