What Kinds Of Out-of-Pocket Costs Can I Expect From My Health Plan?

Your health plan’s "out-of-pocket" costs will include your annual deductible, perhaps a cost-sharing amount that arises from a coinsurance clause (meaning that you may have to pay a percentage of your medical fees while your plan pays the rest), and any medical expenditures that your insurer deems to be in excess of what it considers "reasonable and customary". Only medical expenses that are defined as "reasonable and customary" for a specific service will be eligible for reimbursement under most health insurance plans.

By the way, it’s important to review your individual policy carefully—as the definition of services that are "reasonable and customary" will vary to some extent from one health insurance plan to another.