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Nearly 50% of insured Americans get surprise medical bills: Study

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Nearly half of insured U.S. adults say they’ve gotten a surprise medical bill in the past year for something insurance should have covered. A new study from the Commonwealth Fund shows many of those bills are the result of billing errors or coverage denials.

Still, the study shows less than half of those who were wrongly billed challenged their insurance company or health care provider — even though the study found more than 1 in 3 people who do challenge the surprise charges have their costs either reduced or eliminated completely.

More than half of those surveyed said they didn’t know they had the right to challenge medical billing errors.

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The Commonwealth Fund study also said the consequences of coverage denials were apparent, with 60% of people reporting delays in care and 47% saying their condition got worse while waiting for care. Meanwhile, 17% of people said their insurance denied coverage altogether for certain services or procedures recommended by their doctor.

This survey comes as a growing number of Americans say they’re struggling with medical debt. More than 4 in 10 say they have some sort of medical debt and more than 1 in 10 say they owe $10,000 or more, according to the Senate Health, Education, Labor & Pensions Committee. The HELP committee held a hearing in July about potential fixes to the growing problem.

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NEARLY HALF OF INSURED U-S ADULTS SAY THEY’VE GOTTEN A SURPRISE MEDICAL BILL IN THE PAST YEAR – FOR SOMETHING INSURANCE *SHOULD* HAVE COVERED. 

AND A NEW STUDY FROM THE COMMONWEALTH FUND SHOWS MANY ARE THE RESULT OF BILLING ERRORS OR COVERAGE DENIALS. 

STILL THOUGH – THE STUDY SHOWS LESS THAN HALF OF THOSE WHO WERE WRONGLY BILLED CHALLENGED THEIR INSURANCE COMPANY OR HEALTH CARE PROVIDER… 

EVEN THOUGH THE STUDY FOUND MORE THAN 1 IN 3 PEOPLE WHO *DO* CHALLENGE THE SURPRISE CHARGES – HAVE THEIR COSTS EITHER REDUCED OR ELIMINATED COMPLETELY. 

WHILE MORE THAN HALF OF THOSE SURVEYED SAID THEY DIDN’T KNOW THEY HAD THE RIGHT TO CHALLENGE MEDICAL BILLINGS ERRORS. 

THE COMMONWEALTH FUND STUDY ALSO SAID THE CONSEQUENCES OF COVERAGE DENIALS WERE APPARENT – WITH 60 PERCENT OF PEOPLE REPORTING DELAYS IN CARE… 

AND 47 PERCENT SAYING THEIR CONDITION GOT WORSE WHILE WAITING FOR CARE. 

AND 17 PERCENT OF PEOPLE SAY THEIR INSURANCE DENIED COVERAGE ALTOGETHER FOR CERTAIN SERVICES OR PROCEDURES RECOMMENDED BY THEIR DOCTOR. 

THIS SURVEY COMES AS A GROWING NUMBER OF AMERICANS SAY THEY’RE STRUGGLING WITH MEDICAL DEBT. 

MORE THAN 4 IN 10 SAY THEY HAVE SOME SORT OF MEDICAL DEBT… AND MORE THAN 1 IN 10 SAY THEY OWE 10-THOUSAND DOLLARS OR MORE – ACCORDING TO THE SENATE HEALTH, EDUCATION, LABOR & PENSIONS COMMITTEE… WHICH HELD A HEARING LAST MONTH ABOUT POTENTIAL FIXES TO THE GROWING PROBLEM.