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Out-of-pocket costs refer to medical expenses that an individual must pay directly, without assistance from their insurance plan. This typically includes expenses that are not covered by insurance policies, such as certain treatments, diagnostic services, and specialist visits that may exceed coverage limits or have excluded services. Individuals have to cover these expenses with their own funds.

The other options involve costs associated with insurance coverage or reimbursement. Premiums and co-payments are payments made when utilizing health insurance, but they don't represent out-of-pocket costs in the context of uncovered services. Expenses reimbursed by insurance plans are also not out-of-pocket, as those costs are ultimately covered by the insurance provider after claims are processed. Therefore, the type of expenses that fall into the out-of-pocket category are indeed medical costs that insurance does not cover.