While more people who once had no health insurance are now covered thanks to health care reform, many still struggle to pay medical bills, and are learning that the fine print in their policies is worth reading closely.
The Kaiser Family Foundation teamed up with staffers from the New York Times to gather medical care information from more than 2,500 individuals, about half of who had trouble paying their medical bills.
Twenty percent of those surveyed who had insurance said paying medical bills had caused "serious" disruptions in their lives, including forcing them to shift employment practices to pay the bills and tighten spending in other areas. Still, having coverage proved to be better than not: 53 percent of those who did not have insurance said they struggled with paying medical bills and this led to "serious" challenges for them.
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However, when asked if paying bills had a "major impact" on their lives, about the same percentages of both groups said it did (44 percent insured and 45 percent uninsured).
Other findings:
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Among the insured with problem medical bills, one-quarter received unexpected claim denials; and about one-third received care from an out-of-network provider that their insurance wouldn't cover.
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The out-of-network charges were a surprise for a large majority: 69 percent were unaware that the provider was not in their plan's network when they received the care.
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Among those with private insurance, those in higher deductible plans are more likely to report medical bill problems than those in plans with lower deductibles (26 percent versus 15 percent).
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Three of five with medical bill problems say they've had difficulty paying other bills as a result of their medical debt, and more than a third were unable to pay for basic necessities like food, heat, or housing.
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Almost three of five of those with problems paying medical bills say they've been contacted by a collection agency in the past year. Those who faced medical bill problems with and without insurance are about equally likely to report each of these situations.
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Among those with medical bill problems, 31 percent say the total reached at least $5,000, including 13 percent who say the total reached at least $10,000.
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Of all those with medical bill problems, about three in five are either just meeting their basic expenses (43 percent) or aren't able to do so (18 percent).
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More than half (55 percent) of those with insurance who have medical bill problems say they are either just getting by or don't have enough to make ends meet.
The survey found that many respondents who struggled to pay medical bills have made an effort to find better health coverage, based on their experiences. But about two-thirds said they were essentially unable to easily and successfully navigate the health insurance system to identify coverage that would lower their medical costs.
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Dan Cook
Dan Cook is a journalist and communications consultant based in Portland, OR. During his journalism career he has been a reporter and editor for a variety of media companies, including American Lawyer Media, BusinessWeek, Newhouse Newspapers, Knight-Ridder, Time Inc., and Reuters. He specializes in health care and insurance related coverage for BenefitsPRO.
