Out-of-Pocket Costs

Out of pocket cost | money shotThis is the amount you pay towards health care or prescription drug costs. You have to pay these costs because they aren’t covered by Medicare or other health insurance. This could include coinsurance, co-payments, deductibles, and payments made while in the coverage gap.

After David reached the coverage gap in his Medicare prescription drug plan, he filled a brand name prescription. The amount he paid plus the manufacturer discount amount counted as out-of-pocket spending.