Yes, most Americans pay entirely out of pocket for their healthcare in each given year. That might be surprising, considering that most Americans have health insurance. But most health insurance policies do not prevent you from paying out of pocket.

Before we get into explaining why most patients pay for healthcare out of pocket, let's look at what approaches patients use to pay for healthcare.

How do people pay for healthcare?

Americans pay for healthcare in one of 3 primary ways.  Here is how healthcare was paid for in 2021 (approximately):

• 80% through health insurance
• 10% through other payers like healthshares
• 10% directly

In other words, 90% of people paid through some sort of third-party payer, and only 10% paid directly.  However, that does not mean only 10% paid for healthcare out of pocket.  In fact, the majority paid out of pocket. That's because even patients with third-party payers are subject to deductibles.

Deductibles mean paying out of pocket

Most health insurance and healthshare policies have deductibles. A deductible is the annual amount the patient must pay out of pocket before insurance will start contributing. Most patients don't reach their deductible in a given year. That is largely because most patients have high deductibles, even extremely high deductibles, and deductibles are rising every year.

American Action Forum explains the individual insurance market:

But how many people actually use their insurance benefits? In the individual market, the answer is not most. Aside from a few preventative services, the majority of individuals will not incur medical expenses that exceed their annual deductible. ... In any given year, more than 80 percent of non-chronically ill individuals spend less than the average deductible for a Silver plan in the Health Insurance Marketplace.

The story is similar for the employer insurance market. Most employees have high-deductible health plans. ValuePenguin says: "52.9% of American private-sector workers were enrolled in HDHPs" (meaning high deductible health plans), and notes "HDHP enrollment is on the rise". According to Kaiser Family Foundation, the average annual deductible is $1,945 for an individual and $3,722 for a family on an employer plan. Again, most non-chronically ill patients spend less than the average deductible.

Conclusion

If you don't have health insurance or a healthshare, you will pay out of pocket for all your healthcare. You will pay the highest prices.

If you do have health insurance or a healthshare, you will pay out of pocket up to your deductible. Statistically, you probably won't spend enough on healthcare this year to reach your deductible. That means all of your spending will be out of your own pocket. You will pay mediocre prices at best, because insurers and healthshares aren't motivated to negotiate very hard, and some don't negotiate at all.

If you want to minimize how much you pay out of pocket, and have protection against the notoriously high prices in the United States, visit Pocketero. It is the only network for patients who pay out of pocket. You get the best prices when paying out of pocket for healthcare. It's so affordable that it generally pays for itself with only a single healthcare visit per year. Try it now!