More than half of insured Americans fear a major medical bill

More than half of insured Americans fear a major medical bill

Health insurance is supposed to protect people from high medical costs and help them get the care they need. But a new survey of 1,887 people with health insurance conducted from May through July of this year by GoodRx, a platform for medication savings, shows that having coverage doesn't always mean having affordable access to care.

About 1 in 4 insured respondents said they needed care their plan didn't cover, and a similar portion reported financial strain related to medical costs. Many also worried about whether they could afford future healthcare needs.

The findings highlight several ways people experience underinsurance: Their plan may not cover care they need, they may not be able to afford their share of the cost, or they may lack confidence that their coverage will protect them from a major medical expense.

GoodRx Research has previously documented these pressures in prescription coverage. In 2026, it expanded its research beyond prescription insurance restrictions to examine how underinsurance affects access to care across the healthcare system.

Key takeaways:

* According to new survey data from GoodRx Research, about 1 in 4 insured people said they needed care their plan didn't cover, and a similar portion reported financial strain related to medical costs.

* Prescription costs remain a major pressure point, with 34% of insured respondents reporting higher premiums and 27% reporting higher prescription out-of-pocket costs.

* High costs are also changing how some people access care. Among insured respondents experiencing financial strain, 52% delayed or skipped dental care, 37% postponed vision care or doctor visits, and 31% put off or went without prescription medications because of cost.

* Having insurance doesn't always provide a sense of financial security: 45% of respondents reported anxiety about future healthcare needs or unexpected medical situations, and 56% worried about affording costs from a serious illness or accident.

Rising insurance and out-of-pocket costs

Insured consumers are facing higher costs on several fronts. In the latest GoodRx Research survey, 34% reported an increase in insurance premiums, 26% reported a higher deductible, and 27% reported an increase in prescription out-of-pocket costs.

Those increases can add up and put serious pressure on household budgets. Higher premiums mean paying more to maintain coverage, while higher deductibles and prescription costs can increase what consumers pay when they actually use their benefits.

At the same time, some consumers are seeing changes in what their insurance covers. Nearly 15% of respondents reported having at least one prescription dropped from coverage, including 8.3% who had one prescription dropped and 6.3% who had more than one dropped.

In GoodRx's previous survey conducted from Nov. 8, 2024, to Jan. 21, 2025, 34% of people with a prescription lacked unrestricted insurance coverage for their medication. Nearly 1 in 5 faced insurance restrictions such as prior authorization or step therapy. Among consumers who knew they could potentially get their prescription covered by completing additional requirements, 31% chose not to go through the process. Some switched medications, paid cash, or didn't fill their prescription at all.

Taken together, the findings show that insured consumers may be paying more for coverage while also facing limits on what their coverage provides. Rising premiums, higher deductibles, increasing prescription costs, and changes in prescription coverage can all make insurance more expensive or more difficult to use.

Coverage gaps across healthcare services

Prescription medication affordability and access are only one part of the underinsurance story. The 2026 survey also asked about gaps in medical services and treatments.

About 1 in 4 insured respondents said they needed care that their plan didn't cover, while a similar portion reported financial strain from medical costs. In other words, insurance can fall short in different ways. A plan may exclude medical services and treatments someone needs, or it may cover care but leave patients with costs they struggle to afford.

Coverage gaps show up across many types of care. Among respondents who said they had needed care that their insurance didn't cover, prescription medications were the most commonly reported gap, cited by 47%.

Dental services followed at 35%. Medical procedures or surgeries were reported by 23%, doctor visits by 22%, and vision care by 19%.

The findings show that underinsurance isn't limited to one part of the healthcare system. Having insurance alone doesn't necessarily mean people can obtain and afford the care they need.

When cost prevents and delays care

The services most likely to be inadequately covered weren't always the services most likely to be delayed because of cost.

Prescription medications were the most frequently reported coverage gap, but dental care had the highest rate of cost-related delay or avoidance among respondents experiencing financial strain. That difference highlights two ways underinsurance can limit access: Care may not be covered at all, or a patient's share of the cost may be so high that they don't end up using their plan.

Among insured respondents who reported financial strain due to medical costs, 52% said they delayed or skipped dental care. This was followed by vision care and doctor visits, which were postponed or skipped at a rate of 37% due to cost. Respondents also reported putting off or going without prescription medications (31%), medical procedures or surgeries (29%), and mental health services (23%) because of cost.

People with insurance, then, aren't simply paying more for healthcare. Some are changing how or when they get care because of what it costs them. When costs cause people to delay or skip needed care, a financial problem can become a health problem.

Consumer sentiment about health costs and coverage

Consumers aren't only worried about what healthcare costs them today. Many are also concerned about what will happen the next time they need care.

Among respondents, 45% said they felt anxious about future healthcare needs or unexpected medical situations given their current coverage, and 56% worried about affording out-of-pocket costs after a serious illness or accident.

There are many drivers that can lead to a sense of financial insecurity. One relevant change in the broader insurance environment is the expiration of the enhanced Affordable Care Act (ACA) premium tax credits, which had reduced premiums for millions of people. That policy change can't explain the survey findings on its own, but it's part of a broader environment in which consumers face uncertainty about what healthcare will cost.

The bottom line

Having insurance isn't the same as having reliable access to affordable care. Some insured consumers need services their plans don't cover. Others have coverage but still can't afford their share of the cost. Many also worry that their insurance won't adequately protect them from a serious medical expense.

Insurance status shows who has a plan. Looking at underinsurance helps show whether that plan works when people actually need care.

Methodology

The survey was run through YouGov from May 7, 2026, through July 14, 2026. The sample population was 1,887 adults who reported having a prescription medication during the previous month and had health insurance with prescription drug coverage. National survey responses were weighted to be representative of the U.S. adult population. Survey responses were weighted to the U.S. population using age, gender, race, political affiliation, and education level. State-level survey responses were unweighted. The YouGov survey research arm provides additional details on methodology and weighting.

This story was produced by GoodRx and reviewed and distributed by Stacker.

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