Patient Responsibility

DEFINITION

Patient responsibility is the amount the patient or insurance plan member owes after your insurer has paid everything else. It is usually a combination of your deductible, co-pay, and/or co-insurance. You may have already paid a portion of this amount, and payments made directly to your doctor or health care provider may not be subtracted from this amount. You may also see this referred to as "What You Owe" or "Due from Patient."

EXAMPLE

Juanita saw on her EOB that her co-pay for the doctor's visit was $15. She had already paid her deductible that year, so the deductible column was blank on her EOB. Because insurance covered the rest of the cost of that visit, she only owed $15, which was shown under the 'Patient Responsibility' column.