Medical Bills Still Take A Big Toll, Even With Insurance (2024)

Barbara Radley, of Oshkosh, Wis., has diabetes, liver failure and scleroderma. Even filing for bankruptcy early last year didn't stop her financial woes, she says. The medical bills keep piling up. Jason Houge for NPR hide caption

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Jason Houge for NPR

Medical Bills Still Take A Big Toll, Even With Insurance (2)

Barbara Radley, of Oshkosh, Wis., has diabetes, liver failure and scleroderma. Even filing for bankruptcy early last year didn't stop her financial woes, she says. The medical bills keep piling up.

Jason Houge for NPR

For Barbara Radley, there is "before" and "after." Before was when she could work — moving furniture, and driving a long-haul truck.

"It was nothing for me to throw a couch on my back and carry it up a flight of stairs," says the 58-year-old from Oshkosh, Wis.

Then there's after. After she herniated five disks in her back. And after, she says, her blood pressure medicine destroyed her pancreas.

Now Radley is disabled, suffering from diabetes, liver failure and scleroderma.

And she is bankrupt.

"Well, the medical bills were just piling up," Radley tells Shots. "We couldn't handle it. We just couldn't keep up."

Radley is among the 26 percent of people in a recent poll who say health care expenses have taken a serious toll on family finances. The poll, conducted by NPR, The Robert Wood Johnson Foundation and Harvard's T.H. Chan School of Public Health, shows that even people with medical insurance are still struggling to pay medical bills.

Radley and her husband, also a mover, were getting by on his paycheck and her disability payments, which together brought in about $30,000 a year.

But, two years ago, they were hit with a double whammy. His company changed to a health insurance plan that required the couple to pay higher premiums — about $700 a month — higher copays and a $5,000 deductible.

Then her husband needed emergency surgery and missed a few months of work.

"That just killed us financially," Radley says.

They moved out of their family home and rented a place from her daughter-in-law. They stopped eating out — except once in a while, when they'd get a free meal at their church.

Still they ended up in bankruptcy early last year. They were able to write off their old medical debt, but the health problems didn't go away. Barbara's costs are constant and her husband had another surgery last fall. In the past 12 months they've racked up an additional $10,000 in unpaid medical bills.

"Everybody wants your money and it's like, 'Well, stand in line; you ain't gonna get none,' " Radley says with exasperation.

According to the poll, Radley has plenty of company. Of the people who said health costs have caused them serious problems, 7 percent ended up in bankruptcy.

Radley now makes Faustian bargains on a regular basis.

This week, Radley has been debating whether to take out a payday loan or sell something on Craigslist to cover her insurance plan's $454 copay for a two-month supply of insulin. Jason Houge for NPR hide caption

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Jason Houge for NPR

Medical Bills Still Take A Big Toll, Even With Insurance (4)

This week, Radley has been debating whether to take out a payday loan or sell something on Craigslist to cover her insurance plan's $454 copay for a two-month supply of insulin.

Jason Houge for NPR

"There are times I check my blood for my insulin and I know I only have two pens left," she says. "And I really can't afford it for another week and a half. Well, then I take a lower dose of my insulin. Otherwise I'll just skip it."

But skipping insulin also can be dangerous, Radley knows.

"If I would skip it for several days that would put me in the hospital," she says, "and that just gives me more bills."

On Monday she was trying to decide whether to take out a payday loan or sell something on Craigslist to cover her insurance plan's $454 copay for two months of insulin.

A study last year by the Kaiser Family Foundation found that companies are shifting health care costs to their employees. Workers' share of health insurance premiums for their families rose 83 percent from 2005 to 2015, the survey shows. The amount employees had to pay for deductibles for individual insurance increased 255 percent from 2006 to 2015. The increases are far higher than growth in workers' wages.

That hurts the sickest people the most, says Linda Blumberg, a senior fellow in health policy at the Urban Institute. A study by her organization shows health care has become more affordable since the Affordable Care Act was implemented two years ago. Still, the research found, about 17 percent of adults in the U.S. continue to struggle to pay their medical bills.

"When we see higher deductibles, higher copays, higher coinsurance, higher out-of-pocket maximums on these insurance plans, the people who are most affected are those that have the most need for medical care," Blumberg says.

About 15 percent of those in NPR's poll say that at least once in the past two years, they couldn't get the health care they needed. And 58 percent of those said it was because they couldn't afford it.

Separately, 19 percent of poll respondents say they didn't fill a prescription because of the cost. Mary Lena Warden, 78, of Cleveland, Texas, is among them.

Warden lives alone and uses a wheelchair to get to the drugstore around the corner and to her doctor down the road. She pays $147 a month for Medicare, the government health insurance program for the elderly and the disabled. That's out of the $1,400 she gets each month in Social Security payments.

Warden says she doesn't qualify for extra help, like food stamps or Medicaid, the federal health care program for the poor.

"All my money is gone by the time I pay my rent, my gas, my lights, my water and my copay for the doctor," Warden says. "Everything else is gone."

Just two weeks ago, Warden skipped an appointment for an echocardiogram because she couldn't afford the $100 copay. And she is trying to decide whether to fill a prescription for a drug called Neurontin, which dulls the nerve pain in her leg — pain caused by a severe car accident. The last time she picked up the drug, her copay was $159.95.

"Right now I'm afraid to even buy medicines," Warden says. "I can't afford 'em."

Medicare, like more and more health plans, leaves lot of expenses for patients to cover, says Drew Altman, CEO of the Kaiser Family Foundation.

"The public perception may be that, because Medicare is so popular, it is gold-plated Cadillac coverage," Altman says. "But people who are on Medicare know that those costs can really bite."

Altman says Obamacare has given nearly everyone in the U.S. access to health care. About 89 percent of people now have insurance in some form, according to the Department of Health and Human Services.

But simply having insurance isn't always enough.

The next big challenge, Altman says, is to stop people from going broke when they get sick.

Medical Bills Still Take A Big Toll, Even With Insurance (2024)

FAQs

Why are medical bills so expensive even with insurance? ›

There are many factors that contribute to the high cost of healthcare in the country. These include wasteful systems, rising drug costs, medical professional salaries, profit-driven healthcare centers, the type of medical practices, and health-related pricing.

How to handle large medical bills? ›

How to pay huge medical bills on a small income
  1. Ensure charges are accurate.
  2. Ask about a discount and negotiate the payment amount.
  3. Set up a payment plan.
  4. Find financial assistance.
  5. Look into medical credit cards.
  6. Consider a personal loan.
  7. Contact a medical bill advocate.
  8. Contact an attorney.
Dec 13, 2023

How much medical debt is the average American in? ›

Most of the 20 million adults with medical debt owe over $1,000, and about half (11 million people) owe over $2,000. Among the 20 million adults with medical debt, about 3 million (13%) have debt obligations between $5,001 and $10,000, and another 3 million (14%) owe more than $10,000.

Is medical debt being forgiven? ›

Thanks to the American Rescue Plan (ARP), states, counties, and cities are canceling an estimated $7 billion in medical debt for up to nearly 3 million Americans, including: Arizona is using ARP funds to relieve an estimated up to $2 billion in medical debt for up to 1 million Arizonans.

What is the average hospital bill in the US? ›

The average per-day hospital cost in the U.S. is $2,883, with California ($4,181) the most expensive, and Mississippi ($1,305) the least. The average hospital stay is 4.6 days, at an average cost of $13,262.

What is the most expensive medical bill? ›

Some of the most expensive medical treatments in the world are mostly present here, which is why many people even consider going to Mexico for cheaper medical treatments. It's also not surprising that likely the most expensive hospital bill ever also took place in the U.S. in Florida, worth $9.2 million.

What do I say to lower my medical bill? ›

Reach out to the billing office to ask for a reduced fee. You can usually find their phone number on your bill. "Ask if you qualify for charity care or financial assistance programs," said Latham. "Just asking for this can often cut your debt in half.

Can you write off large medical expenses? ›

Key Takeaways. The IRS allows all taxpayers to deduct their qualified unreimbursed medical care expenses that exceed 7.5% of their adjusted gross income. You must itemize your deductions on IRS Schedule A in order to deduct your medical expenses instead of taking the standard deduction.

How do I hide assets from medical bills? ›

Setting up an irrevocable trust can help protect your assets from medical expenses, as the assets covered by the trust cannot be claimed by creditors. Another way to protect your home can be by transferring the ownership to a family member. This can protect your home from being seized to pay medical bills.

What happens in America if you can't afford healthcare? ›

Not having health insurance can lead to large debt, affect your health if you delay care and may even hurt you at tax time, depending on your state.

How many people don't go to the hospital because of medical bills? ›

The cost of health care can lead some to put off needed care. One in four adults say that in the past 12 months they have skipped or postponed getting health care they needed because of the cost. Notably six in ten uninsured adults (61%) say they went without needed care because of the cost.

Which states have the highest medical debt? ›

Zoom in: South Dakota (17.7%), Mississippi (15.2%), North Carolina (13.4%), West Virginia (13.3%) and Georgia (12.7%) had the highest shares of adults with medical debt on average between 2019-2021. During that time, West Virginia was the only one of those states with expanded Medicaid coverage for low-income adults.

Can medical bills ruin your credit? ›

Medical debt is not reported to credit bureaus as long as it remains with your healthcare provider. If you don't pay the bill for at least three months, however, your provider may sell it to a collections agency. That's when it can ding your credit score.

Is it worth it to pay off medical debt? ›

Unpaid medical debts, like other missed bill payments, reflect poorly on you and can have a negative effect on your credit score. However, that will not happen immediately, so you have time to settle your debt and stay in good financial health.

Can medical bills under $500 be sent to collections? ›

Key takeaways. As of April 2023, medical debt under $500 in collections and any medical debt that's been paid off no longer appears on consumers credit reports. Likewise, medical debt over $500 is not reported to the credit bureaus until a year after going to collections.

Why is my medicine more expensive with insurance? ›

Consumers may also pay more if they are covered by plans that require them to pay a set co-payment, no matter the cash price. In some of those cases, the insurers require the pharmacies to send them the difference between what they collect from the consumer and what the insurers have agreed to reimburse the pharmacies.

What is the real reason healthcare is so expensive? ›

Important factors underlying the price problem include high levels of health care industry consolidation coupled with limited oversight of prices, and the high degree of administrative complexity in our U.S. health care system.

Why is health insurance so unaffordable? ›

Administrative Overhead: Health insurers often have substantial administrative overhead, including marketing, underwriting, and claims processing. These costs are passed on to consumers in the form of higher premiums, which can contribute to overall healthcare expenditure.

When did US healthcare become so expensive? ›

Since 2008, the average cost of a family health insurance premium has risen 75% compared to a 42% increase in average hourly wages and a 26% increase in inflation. “Many workers probably don't realize that family premiums have exceeded $20,000 a year.

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