Many Forgo Healthcare Due to Out-of-Pocket Costs, Even with Private Insurance

Many Forgo Healthcare Due to Out-of-Pocket Costs
Many Forgo Healthcare Due to Out-of-Pocket Costs

(HealthDay News) — Many Americans may believe that private insurance can keep major medical bills at bay. But a new survey finds that one-fifth of people with private plans still spend at least 5% of their income on out-of-pocket health care costs.

The findings, from the research group The Commonwealth Fund, found that 21% of adults with health coverage spent ≥5% of their income on out-of-pocket costs – not including premiums – over the past year, and 13% spent ≥10% or more. The problem was most common among low-income adults, with 41% of those who made less than $11,490 a year spending ≥5% or more of their income on out-of-pocket costs, and 31% spending ≥10% or more.

Many low- and moderate-income adults with high out-of-pocket costs skipped needed care or medications, the survey found. Among those with yearly incomes of less than $22,980, 46% skipped needed care at least once due to their health plan's copayments or coinsurance, 28 percent did not fill a prescription, 28% skipped a medical test or follow-up treatment, 30% did not see a doctor when they had a health problem, and 24% did not see a specialist when their doctor recommended seeing one. Among people with private insurance who spent at least 5% of their income on out-of-pocket health costs, 40% said they skipped needed care at least once due to their plan deductibles, 29% skipped a medical test or follow-up treatment, 27% did not see a doctor for a health problem, 23% skipped a preventive care test, and 22% did not see a specialist despite their doctor's advice to do so.

Overall, 13% of adults with private health insurance have plans that include a deductible equal to ≥5% or more of their income. Forty-three percent of adults said their deductibles are somewhat, very difficult, or impossible to afford.

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