Can you do a cash-out refinance where you actually have to bring money in rather than receive cash?

Yes, that is a real thing, and more common than you would expect. It happens when the best available terms cap a cash-out loan at a certain loan-to-value, often around 80 percent, but the debt you want to pay off runs past what that loan covers. To retire the rest and land on a loan you actually qualify for, you bring money to the table, from savings or sometimes a retirement withdrawal, instead of walking away with cash. Technically the loan is still structured as a cash-out refinance. You are just the one contributing funds to make the numbers work. Where this earns its keep is restructuring after a hard stretch. When a serious illness or a divorce leaves someone with scattered high-interest debt, folding that debt into the mortgage, even at the cost of bringing cash in, can stabilize the monthly picture and lower total payments. We have called it a get-out-of-jail-free option in those cases. The caution is the flip side. Consolidating genuine debt after a hardship is a world away from tapping equity to fund a lifestyle, and home equity makes a poor ATM. If your situation is the former, run the numbers, because bringing some cash to close can get you meaningfully better terms on the whole loan.