Simply having health insurance coverage is not enough to convince many consumers that they can afford their health care, according to a new poll.

One in four privately insured adults doubt they could pay for a major illness or injury, according to poll results released this month by the Associated Press and NORC Center for Public Affairs Research. People with high-deductible plans expressed the greatest concern.

This reality is causing some consumers to make choices that could harm their health in the long run:

• 19 percent of all privately insured adults said they did not go to the doctor when they were sick or injured, because of costs. Among those with high-deductible plans, the figure was 29 percent;
• 17 percent skipped a recommended test or treatment; 23 percent among those with high-deductible plans; and
• 18 percent of all adults went without a physical exam or other preventive care; 24 percent among those with high-deductible plans.

Other consumers are adjusting their lifestyles to be able to afford medical bills:

• 33 percent said they cut back on entertainment; 43 percent among those with high-deductible plans;
• 18 percent said they used up all or most of their savings; 24 percent among those with high-deductible plans; and
• 19 percent said they dialed down their contributions for retirement savings; 28 percent for people with high-deductible plans.

The poll also found signs of dissatisfaction among people who changed plans in the last year, as the Patient Protection and Affordable Care Act went into full effect. Forty-nine percent said they are paying more, compared to 29 percent who are paying less. Of those paying more, only 11 percent report receiving better care.