Healthcare News: What Are Out-Of-Pocket Expenses?


“A majority of patients (59%) paid an average out-of-pocket expense between $500 and $1,000 during a healthcare visit in 2018, a marked increase from 39% the year prior.”[1]  What are out of pocket expenses? Healthcare 101 will be our jumping off spot. In the United States, health insurance is any program that helps pay for medical expenses, whether through privately purchased insurance, employer-sponsored healthcare coverage, or a health plan funded by the government. Or out of your own pocket. [2]

That said, there are certain requirements the health care consumer must meet before the cost of healthcare can be handed off to whoever the “PAYOR” might be.  Those costs not covered by the PAYOR often means that the PAYOR becomes you, the patient. These are the dreaded OUT OF POCKET HEALTHCARE COSTS.

And while the average amount of MONEY OUT OF YOUR POCKET was $500-1,000, greater than one in every ten of you had out of pocket costs of $1,000 or more. “The analysis reveals that patients experienced annual increases of up to 12% in their out-of-pocket responsibilities for inpatient, outpatient and emergency department care in 2018.[3]“ It should come as no surprise that healthcare cost is important.

And one area where you thought you might be the safest are those of you who get your healthcare through your employers. That would be roughly 49% of Americans with some sort of healthcare coverage.

The ability to see the doctor of your choice is called ACCESS. According to the Kaiser Family Foundation[4], you obtain ACCESS to the doctor of your choice from one of the following.[5]

Employer: Includes those covered by employer-sponsored coverage, either through their own job or as a dependent in the same household. Health insurance provided to employees by an employer or by an association to its members is called group coverage.

For an average family of four, your out of pocket costs have gone from $4,617 in 2008 to almost $8,000 in 2018.[6] Here are a few more pieces of data concerning Employer sponsored health plans.

out of pocket medical costs-employees

other data on employer healthplans chart


[1] Liss, Samantha, “Majority of patients faced out-of-pocket expense of $500 or more last year,” HealthCareDive, 26 Jun 2019,

[2] Earthquake-How the Ever-shifting Healthcare Model Victimizes Americans, Copyright @ 2019 by Brian H. Casull, MD, MPA

[3] “Out-of-Pocket Costs Rising Even as Patients Transition to Lower Cost Settings of Care,” TansUnion, 25 jun 2019,

[4] Data is based on analysis of the Census Bureau’s American Community Survey (ACS) by the Kaiser Family Foundation. The ACS asks respondents about their health insurance coverage at the time of the survey. Respondents may report having more than one type of coverage; however, individuals are sorted into only one category of insurance coverage.

[5]  “Health Insurance Coverage of the Total Population.” The Henry J. Kaiser Family Foundation, The Henry J. Kaiser Family Foundation, 29 Nov. 2018,

[6] Cerullo, Megan, “Here’s how much a family with good health insurance spent last year,” CBS News 21 Aug 2019

By | 2019-11-05T10:46:41+00:00 November 19th, 2019|Categories: Healthcare|0 Comments

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