Selfpay

Self-pay refers to paying for goods or services directly with cash or a debit/credit card at the time of service or after receiving a bill, without using an insurance plan or third-party payer. In healthcare, self-pay most often describes patients who pay out of pocket for medical, dental, or vision services, either because they are uninsured, underinsured, or choose not to claim benefits through insurance. Hospitals, clinics, and urgent care centers may offer self-pay pricing, including advertised cash prices or self-pay discounts, and may provide financial counseling or installment plans to manage costs. The self-pay market has grown in part due to increasing prevalence of high-deductible health plans, cost-sharing, and gaps in insurance coverage.

Self-pay transactions can involve upfront payment at the point of service, post-visit billing, or payment plans that extend over time. Some providers publish price transparency information, and many jurisdictions regulate or encourage price disclosure. Providers may also seek to classify patients into self-pay categories for reporting and revenue cycle management.

Advantages for patients include privacy and potentially lower prices when paying cash, while disadvantages include high out-of-pocket burden, variable pricing, and limited access to negotiated rates or insurance protections. For providers, self-pay can simplify billing and reduce insurer-related delays, but can also raise bad debt risk and require more extensive financial counseling. Policy context includes reforms in some regions that encourage price transparency and limit balance billing, while the term remains most commonly used in the United States.