In 2022, U.S. out-of-pocket health care payments was reported to come to an average of ******* U.S. dollars per capita. In the U.S., especially out-of-pocket payments for prescribed drugs can be very high. This statistic depicts the per capita out-of-pocket health care payments in the United States from 1970 to 2022.

In the United States, average employee premium contributions and deductibles as a percentage of median household income have risen in the past decade. In 2020, an employee’s total potential out-of-pocket medical costs (premium and deductible) amounted to 11.6 percent of median income. This included 6.9 percent in employee premium contributions and 4.7 percent in deductibles. However, states varied greatly in median income spent on premiums and deductibles, with workers in Mississippi having to spend on average 19 percent of their income on potential out-of-pocket medical costs.

Employer sponsored health insurance In 2020, over half of the U.S. population has some type of employment-based health insurance coverage. The Affordable Care Act penalizes large employers (with 50 or more full-time employees), if they do not provide health insurance to their employees. Nevertheless, of the uninsured aged under 65 years, the large majority worked either full or part-time (or someone in their household did).

Out-of-pocket medical costs Despite having insurance coverage, most plans have a deductible, the amount an insured must pay themselves that year before their insurance starts covering for them. The average annual deductible for single coverage amounted to roughly 1,700 U.S. dollars in 2021. Even after reaching their deductible, most insured have other forms of out-of-pocket health costs in the form of co-payments and co-insurance for health services or prescription drugs.

In 2020, the average out-of-pocket (OOP) spending on healthcare services per person in the U.S. for women amounted to ***** U.S. dollars, and for men, was ***** U.S. dollars. During the provided time interval, women on average spend approximately ************* U.S. dollars more than men OOP annually on healthcare services.

This dataset contains data for the Healthcare Payments Data (HPD): Medical Out-of-Pocket Costs and Chronic Conditions report. The data covers three measurement categories: annual member count, annual median out-of-pocket count, annual median claim count. The annual member count quantify the number of unique individuals who received at least one medical service in the reporting year. Annual median out-of-pocket measurements quantifies the sum of copay, coinsurance, and deductible incurred by members. Annual median claim count measurements quantifies the number of distinct claims or encounters associated with members. Both 25th and 75th percentiles for out-of-pocket cost and claim count are also included. Measures are grouped by payer types, chronic conditions flag, chronic condition types, and chronic condition numbers.

United States US: Proportion of Population Spending More Than 25% of Household Consumption or Income on Out-of-Pocket Health Care Expenditure: % data was reported at 0.781 % in 2013. This records a decrease from the previous number of 0.856 % for 2012. United States US: Proportion of Population Spending More Than 25% of Household Consumption or Income on Out-of-Pocket Health Care Expenditure: % data is updated yearly, averaging 0.880 % from Dec 1995 (Median) to 2013, with 18 observations. The data reached an all-time high of 1.078 % in 2000 and a record low of 0.724 % in 2008. United States US: Proportion of Population Spending More Than 25% of Household Consumption or Income on Out-of-Pocket Health Care Expenditure: % data remains active status in CEIC and is reported by World Bank. The data is categorized under Global Database’s USA – Table US.World Bank: Poverty. Proportion of population spending more than 25% of household consumption or income on out-of-pocket health care expenditure, expressed as a percentage of a total population of a country; ; Wagstaff et al. Progress on catastrophic health spending: results for 133 countries. A retrospective observational study, Lancet Global Health 2017.; Weighted Average;

Household out-of-pocket payment’ means a direct payment for healthcare goods and services from the household primary income or savings, where the payment is made by the user at the time of the purchase of goods or the use of the services. Data are collected according to Commission Regulation (EC) 2015/359 as regards statistics on healthcare expenditure and financing (System of Health Accounts 2011 manual).

Mexico MX: Out-of-Pocket Health Expenditure: % of Current Health Expenditure data was reported at 40.378 % in 2016. This records an increase from the previous number of 40.189 % for 2015. Mexico MX: Out-of-Pocket Health Expenditure: % of Current Health Expenditure data is updated yearly, averaging 45.647 % from Dec 2000 (Median) to 2016, with 17 observations. The data reached an all-time high of 55.664 % in 2003 and a record low of 39.871 % in 2013. Mexico MX: Out-of-Pocket Health Expenditure: % of Current Health Expenditure data remains active status in CEIC and is reported by World Bank. The data is categorized under Global Database’s Mexico – Table MX.World Bank.WDI: Health Statistics. Share of out-of-pocket payments of total current health expenditures. Out-of-pocket payments are spending on health directly out-of-pocket by households.; ; World Health Organization Global Health Expenditure database (http://apps.who.int/nha/database).; Weighted average;

IntroductionThis study aimed to estimate the direct medical costs and out-of-pocket (OOP) expenses associated with inpatient and outpatient care for IHD, based on types of health insurance. Additionally, we sought to identify time trends and factors associated with these costs using an all-payer health claims database among urban patients with IHD in Guangzhou City, Southern China.MethodsData were collected from the Urban Employee-based Basic Medical Insurance (UEBMI) and the Urban Resident-based Basic Medical Insurance (URBMI) administrative claims databases in Guangzhou City from 2008 to 2012. Direct medical costs were estimated in the entire sample and by types of insurance separately. Extended Estimating Equations models were employed to identify the potential factors associated with the direct medical costs including inpatient and outpatient care and OOP expenses.ResultsThe total sample included 58,357 patients with IHD. The average direct medical costs per patient were Chinese Yuan (CNY) 27,136.4 [US dollar (USD) 4,298.8] in 2012. The treatment and surgery fees were the largest contributor to direct medical costs (52.0%). The average direct medical costs of IHD patients insured by UEBMI were significantly higher than those insured by the URBMI [CNY 27,749.0 (USD 4,395.9) vs. CNY 21,057.7(USD 3,335.9), P < 0.05]. The direct medical costs and OOP expenses for all patients increased from 2008 to 2009, and then decreased during the period of 2009–2012. The time trends of direct medical costs between the UEBMI and URBMI patients were different during the period of 2008-2012. The regression analysis indicated that the UEBMI enrollees had higher direct medical costs (P < 0.001) but had lower OOP expenses (P < 0.001) than the URBMI enrollees. Male patients, patients having percutaneous coronary intervention operation and intensive care unit admission, patients treated in secondary hospitals and tertiary hospitals, patients with the LOS of 15–30 days, 30 days and longer had significantly higher direct medical costs and OOP expenses (all P < 0.001).ConclusionsThe direct medical costs and OOP expenses for patients with IHD in China were found to be high and varied between two medical insurance schemes. The type of insurance was significantly associated with direct medical costs and OOP expenses of IHD.

This data includes the top 25 list for costliest prescribed drugs, most frequently prescribed drugs and the prescribed drugs with the highest monthly median out-of-pocket cost for members. Each of these top 25 lists are broken out by payer type (i.e., All Payers, All Payers W/O Medi-Cal, Commercial, Medicare or Medi-Cal) and drug category (i.e., All, Brand, Generic, Biosimilar or Biologic). The includes National Drug Code (NDC), Year, Top 25 Ranking, National Drug Code, Drug Name, number of prescriptions, number of individuals, total costs, average cost per unit, average dispensed units per fill, drug unit of measure, monthly median out-of-pocket cost, 25th percentile for monthly out-of-pocket cost, 75th percentile for monthly out-of-pocket cost, and percent of monthly out-of-pocket cost with zero dollar amounts for each NDC in each top 25 list.

The United States has the highest expenditure on health care per capita globally. However, the U.S. has an unique way of paying for their health care where a majority of the expenditure falls upon private insurances. In FY 2024, around one ***** of all health expenditure is paid by private insurance. Public insurance programs Medicare and Medicaid accounted for ** and ** percent, respectively, of health expenditure during that same year. U.S. health care system Globally health spending has been increasing among most countries. However, the U.S. has the highest public and private per capita health expenditure among all countries globally, followed by Switzerland. As of 2020, annual health care costs per capita in the United States totaled to over ** thousand U.S. dollars, a significant amount considering the average U.S. personal income is around ** thousand dollars. Out of pocket costs in the U.S. Aside from overall high health care costs for U.S. residents, the total out-of-pocket costs for health care have been on the rise. In recent years, the average per capita out-of-pocket health care payments have exceeded *** thousand dollars. Physician services, dental services and prescription drugs account for the largest proportion of out-of-pocket expenditures for U.S. residents.

Cuba CU: Out-of-Pocket Health Expenditure: % of Current Health Expenditure data was reported at 10.308 % in 2016. This records an increase from the previous number of 9.644 % for 2015. Cuba CU: Out-of-Pocket Health Expenditure: % of Current Health Expenditure data is updated yearly, averaging 12.272 % from Dec 2000 (Median) to 2016, with 17 observations. The data reached an all-time high of 20.340 % in 2003 and a record low of 8.100 % in 2009. Cuba CU: Out-of-Pocket Health Expenditure: % of Current Health Expenditure data remains active status in CEIC and is reported by World Bank. The data is categorized under Global Database’s Cuba – Table CU.World Bank.WDI: Health Statistics. Share of out-of-pocket payments of total current health expenditures. Out-of-pocket payments are spending on health directly out-of-pocket by households.; ; World Health Organization Global Health Expenditure database (http://apps.who.int/nha/database).; Weighted average;

Philippines PH: Out-of-Pocket Health Expenditure: % of Current Health Expenditure data was reported at 53.545 % in 2015. This records a decrease from the previous number of 55.360 % for 2014. Philippines PH: Out-of-Pocket Health Expenditure: % of Current Health Expenditure data is updated yearly, averaging 54.441 % from Dec 2000 (Median) to 2015, with 16 observations. The data reached an all-time high of 58.893 % in 2011 and a record low of 41.195 % in 2000. Philippines PH: Out-of-Pocket Health Expenditure: % of Current Health Expenditure data remains active status in CEIC and is reported by World Bank. The data is categorized under Global Database’s Philippines – Table PH.World Bank.WDI: Health Statistics. Share of out-of-pocket payments of total current health expenditures. Out-of-pocket payments are spending on health directly out-of-pocket by households.; ; World Health Organization Global Health Expenditure database (http://apps.who.int/nha/database).; Weighted average;

United States US: Out-of-Pocket Health Expenditure: % of Private Expenditure on Health data was reported at 21.365 % in 2014. This records a decrease from the previous number of 21.927 % for 2013. United States US: Out-of-Pocket Health Expenditure: % of Private Expenditure on Health data is updated yearly, averaging 23.966 % from Dec 1995 (Median) to 2014, with 20 observations. The data reached an all-time high of 26.623 % in 1998 and a record low of 21.365 % in 2014. United States US: Out-of-Pocket Health Expenditure: % of Private Expenditure on Health data remains active status in CEIC and is reported by World Bank. The data is categorized under Global Database’s USA – Table US.World Bank: Health Statistics. Out of pocket expenditure is any direct outlay by households, including gratuities and in-kind payments, to health practitioners and suppliers of pharmaceuticals, therapeutic appliances, and other goods and services whose primary intent is to contribute to the restoration or enhancement of the health status of individuals or population groups. It is a part of private health expenditure.; ; World Health Organization Global Health Expenditure database (see http://apps.who.int/nha/database for the most recent updates).; Weighted average;

Trinidad and Tobago TT: Out-of-Pocket Health Expenditure: % of Current Health Expenditure data was reported at 37.333 % in 2015. This records an increase from the previous number of 36.581 % for 2014. Trinidad and Tobago TT: Out-of-Pocket Health Expenditure: % of Current Health Expenditure data is updated yearly, averaging 44.590 % from Dec 2000 (Median) to 2015, with 16 observations. The data reached an all-time high of 50.233 % in 2004 and a record low of 35.633 % in 2010. Trinidad and Tobago TT: Out-of-Pocket Health Expenditure: % of Current Health Expenditure data remains active status in CEIC and is reported by World Bank. The data is categorized under Global Database’s Trinidad and Tobago – Table TT.World Bank.WDI: Health Statistics. Share of out-of-pocket payments of total current health expenditures. Out-of-pocket payments are spending on health directly out-of-pocket by households.; ; World Health Organization Global Health Expenditure database (http://apps.who.int/nha/database).; Weighted average;

Additional file 3: Table S2. Estimated Average Health Care Utilization and Out-of-pocket Medical Spending Difference in Medical Aid Type II panel by difference-in-differences analysis. * Log Link with Zero-Inflated Negative Binomial Distribution was applied in the regression analysis because of exceess zeros in the outcomes. a Models additionally adjusted for individuals’ health related characteristics (mostly visited type of medical institution, lasted period of chronic disease). b Propensity score matched for sex, age, region, equivalized household disposable income, marital status, economic activity status, number of private insurance, expenditure on private insurance.

In 2010, South Africa launched a countrywide effort to scale up its voluntary medical male circumcision (VMMC) program on the basis of compelling evidence that circumcision reduces men’s risk of acquiring HIV through heterosexual intercourse. Even though VMMC is free there, clients can incur indirect out-of-pocket costs (for example transportation cost or foregone income). Because these costs can be barriers to increasing the uptake of VMMC services, we assessed them from a client perspective, to inform VMMC demand creation policies. Costs (calculated using a bottom-up approach) and demographic data were systematically collected through 190 interviews conducted in 2015 with VMMC clients or (for minors) their caregivers at 25 VMMC facilities supported by the government and the President’s Emergency Plan for AIDS Relief in eight of South Africa’s nine provinces. The average age of VMMC clients was 22 years and nearly 92% were under 35 years of age. The largest reported out-of-pocket expenditure was transportation, at an average of US$9.20 (R 100). Only eight clients (4%) reported lost days of work. Indirect expenditures were childcare costs (one client) and miscellaneous items such as food or medicine (20 clients). Given competing household expense priorities, spending US$9.20 (R100) per person on transportation to access VMMC services could be a significant burden on clients and households, and a barrier to South Africa’s efforts to create demand for VMMC. Thus, we recommend a more focused analysis of clients’ transportation costs to access VMMC services.

United Arab Emirates AE: Out-of-Pocket Health Expenditure: % of Current Health Expenditure data was reported at 17.790 % in 2015. This records a decrease from the previous number of 17.808 % for 2014. United Arab Emirates AE: Out-of-Pocket Health Expenditure: % of Current Health Expenditure data is updated yearly, averaging 20.015 % from Dec 2000 (Median) to 2015, with 16 observations. The data reached an all-time high of 30.408 % in 2004 and a record low of 15.086 % in 2001. United Arab Emirates AE: Out-of-Pocket Health Expenditure: % of Current Health Expenditure data remains active status in CEIC and is reported by World Bank. The data is categorized under Global Database’s United Arab Emirates – Table AE.World Bank: Health Statistics. Share of out-of-pocket payments of total current health expenditures. Out-of-pocket payments are spending on health directly out-of-pocket by households.; ; World Health Organization Global Health Expenditure database (http://apps.who.int/nha/database).; Weighted Average;

In 2024, the out-of-pocket health care payments in Canada were projected to come to an average of approximately ***** Canadian dollars per capita, an increase from the previous year. This statistic depicts the per capita out-of-pocket health care payments in Canada from 2010 to 2024.

Monaco MC: Out-of-Pocket Health Expenditure: % of Current Health Expenditure data was reported at 7.560 % in 2022. This records an increase from the previous number of 6.887 % for 2021. Monaco MC: Out-of-Pocket Health Expenditure: % of Current Health Expenditure data is updated yearly, averaging 6.075 % from Dec 2000 (Median) to 2022, with 23 observations. The data reached an all-time high of 7.560 % in 2022 and a record low of 5.372 % in 2010. Monaco MC: Out-of-Pocket Health Expenditure: % of Current Health Expenditure data remains active status in CEIC and is reported by World Bank. The data is categorized under Global Database’s Monaco – Table MC.World Bank.WDI: Social: Health Statistics. Share of out-of-pocket payments of total current health expenditures. Out-of-pocket payments are spending on health directly out-of-pocket by households.;World Health Organization Global Health Expenditure database (http://apps.who.int/nha/database). The data was retrieved on April 4, 2025.;Weighted average;

Context

This indicator calculates the average expenditure on health per person. It contributes to understand the health expenditure relative to the population size facilitating international comparison. The Organization for Economic Co-operation and Development (OECD) defines current health spending as:

Health spending measures the final consumption of health care goods and services (i.e. current health expenditure) including personal health care (curative care, rehabilitative care, long-term care, ancillary services and medical goods) and collective services (prevention and public health services as well as health administration), but excluding spending on investments. Health care is financed through a mix of financing arrangements including government spending and compulsory health insurance (“Government/compulsory”) as well as voluntary health insurance and private funds such as households’ out-of-pocket payments, NGOs and private corporations (“Voluntary”). This indicator is presented as a total and by type of financing (“Government/compulsory”, “Voluntary”, “Out-of-pocket”) and is measured as a share of GDP, as a share of total health spending and in USD per capita (using economy-wide PPPs).

OECD (2020), Health spending (indicator). doi: 10.1787/8643de7e-en (Accessed on 19 September 2020)