Older adults are especially vulnerable to the rising costs of health care. In fact, financial professionals have seen that seniors are woefully unprepared for covering costly medical bills in retirement. These strategies can help adults – of all ages – face the challenges.
Medical debt may seem as though it’s a problem limited largely to people who lack adequate health insurance coverage. But even those who have a health plan may find themselves struggling to pay their costly medical bills. According to a 2023 study from health care advocacy organization The Commonwealth Fund, 30% of adults with employer coverage were paying off debt from medical or dental care, as were 33% of those with Medicare, 33% of those with an individual or Affordable Care Act marketplace plan, and 21% with Medicaid. Cutbacks to Medicaid funding in the One Big Beautiful Bill Act, which became law over the summer of 2025, have raised concerns that more people will find themselves enmired in medical debt.
“It’s such a common burden because of the complexity and lack of affordability in our health care system, even if you have insurance,” says Ruth Landé, vice president of provider relations at Undue Medical Debt, a nonprofit organization working to alleviate the burden of medical debt.
If you rack up big bills while you’re still subject to your health plan’s annual deductible, you may be on the hook for thousands of dollars before your insurance coverage starts — especially if you have a high-deductible plan. And even after insurance kicks in, the out-of-pocket costs for co-payments, coinsurance, or charges for out-of-network care can stack up.
Hospital stays and surgeries or serious illnesses that require inpatient care, such as appendicitis or a heart attack, often have hefty costs for patients. Bills for room charges, surgeons, anesthesia or imaging can quickly accumulate. Emergency room visits are also a driver of medical debt, although thanks to the federal No Surprises Act, patients can’t be billed more than the in-network rate for emergency care, even at an out-of-network hospital or if some of the providers are in network and some are out of network.
Treatment for chronic illness is another common culprit. Conditions such as diabetes, cancer, heart disease, asthma and autoimmune disorders require regular care, tests and medications, and ongoing expenses for treatments such as insulin, chemotherapy and dialysis can add up. Insurance plans may cover only certain treatments, medications or specialists. Some newer or specialized drugs or therapies may be only partially covered – or receive no coverage at all – and the specialists you prefer to visit may not participate in your insurer’s network, resulting in substantial out-of-pocket expenses for you.
Costly medical bills may feel insurmountable, but the worst move you can make is to ignore them or forgo care that you need out of fear of going into debt. According to the Commonwealth survey, nearly two in five working-age adults had delayed or skipped needed health care or a prescription drug in the past year because they couldn’t afford it. If you’ve received a medical bill that you can’t pay, or if you’re already in debt, you can take action to get some relief.
Strategies for avoiding costly medical bills
- Confirm that the charges are accurate. Make sure that you truly owe the charges you’re being asked to pay. Review copies of your bills, explanations of benefits (EOBs) and other communication from your insurance company and health care providers as soon as you get them. Insurance companies typically send EOBs in the mail, but you can also usually find them by logging in to your account on the insurer’s online portal. If you can’t locate an EOB for a medical service you received, call your health care provider to be sure it has your insurance information and that it billed the insurance company.
- Look for problems such as duplicate charges, charges for services you didn’t receive, incorrect information about you and any medical conditions you may have, and billing for an out-of-network provider when you visited an in-network one. If you notice that your insurance company paid for a service you didn’t receive, you should point that out, too; even though you may not owe any money, incorrect billing can still be a problem for you because it could cause denials of future claims if the insurance company thinks you already had certain treatments. And keep in mind that if you get a bill long after you received a medical service, it may be because of ongoing disputes between health care providers and insurance companies, says Landé.
- Reach out to the provider or insurance company as soon as possible if anything looks out of place or you don’t understand your charges — and consider doing so by e-mail to keep a paper trail. If your insurance company is denying coverage that you believe you deserve, you can appeal it.
- If your health care provider or insurance company fails to resolve inaccurate bills, you can file a complaint with your state’s department of health (find its website at www.usa.gov/state-health), its department of insurance (https://content.naic.org/state-insurance-departments) or, sometimes, its attorney general (www.naag.org/find-my-ag). These entities can review your complaint, and they may contact the provider or insurer to investigate, though the extent to which they take action to help you will vary by state. For example, the Illinois Department of Insurance reviews complaints about insurance billing and can take corrective action if necessary, as does the New York State Attorney General’s Health Care Bureau.
- Create a payment plan. Once you establish that you’re responsible for a bill, the next step is to figure out a plan to pay it. If you can’t afford it up front, make that clear to the health care provider. “Providers often just don’t know the economic circumstances of folks. But if they do, they can classify your care as charitable care or offer financial assistance,” says Landé. Even if you have health insurance, you may qualify for assistance. They may forgive a portion of your bill or, sometimes, all of it. Most providers also allow patients to set up zero-interest payment plans. If you need some extra guidance, consider reaching out to a nonprofit organization such as Dollar For (https://dollarfor.org), which offers free help navigating medical financial-assistance applications.
Although it may be tempting to pay a medical bill with a credit card – especially if the bill is unexpectedly large and you don’t have money readily available to pay it – avoid doing so at all costs, says Landé. If you carry a balance from month to month on your card, you’ll likely pay interest on that debt at a steep rate – an average of 20%, according to Bankrate – making costly medical bills even more costly.
Emma Patch is a senior writer at Kiplinger Personal Finance magazine. For more on this and similar money topics, visit Kiplinger.com.
©2025 The Kiplinger Washington Editors, Inc. Distributed by Tribune Content Agency, LLC.
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