en Health Management and Economics Health Management and Economics Original Research Original Research <p><strong>Background: </strong>Studies have shown that people using complementary health insurances have more access to health services than others. In the present study, we aimed at finding the differences between out- of- pocket payments and health service utilizations in complementary health insurances (CHIs) users and nonusers.<br> <strong>&nbsp;&nbsp; Methods:</strong>&nbsp; Propensity score matching was used to compare the 2 groups. First, confounder variables were identified, and then propensity score matching was used to compare out- of- pocket expenditures with dental, general physician, hospital inpatient, emergency services, nursing, midwifery, laboratory services, specialists and rehabilitation services utilization.<br> <strong>&nbsp;&nbsp; Results:</strong> Our results revealed no significant differences between the 2 groups in out- of- pocket health expenditures. Also, the specialist visits, inpatient services at the hospital, and dental services were higher in people who used CHIs compared to nonusers.<br> <strong>&nbsp;&nbsp; Conclusion:</strong> People did not change their budget share for health care services after using CHIs. The payments were equal for people who were not CHIs users due to the increase in the quantity of the services.<br> &nbsp;</p> Complementary insurances, Propensity scoring matching method, Out- of- pocket expenditures, General physicians, Dental services, Specialists 339 343 http://mjiri.iums.ac.ir/browse.php?a_code=A-10-1841-4&slc_lang=en&sid=1 Enayatollah Homaie Rad homaierad@gmail.com 200319475328460034002 200319475328460034002 No Guilan Road Trauma Research Center, Guilan University of Medical Sciences, Rasht, Iran. Zahra Kavosi zhrkavosi@gmail.com 200319475328460034003 200319475328460034003 No School of Health Management and Informatics, Shiraz University of Medical Sciences, Shiraz, Iran. Mohammad Taghi Moghadamnia moghaddamnia92 200319475328460034004 200319475328460034004 No School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Masoud Arefnezhad arefnezhad67@yahoo.com 200319475328460034005 200319475328460034005 Yes School of Health, Zabol University of Medical Sciences, Zabol, Iran. Masoumeh Arefnezhad ehomaie@gmail.com 200319475328460034006 200319475328460034006 No School of Health, Zabol University of Medical Sciences, Zabol, Iran. Banfashe Felezi Nasiri felezib@gmail.com 200319475328460034007 200319475328460034007 No Guilan Road Trauma Research Center, Guilan University of Medical Sciences, Rasht, Iran.