Millions of Insured Americans Face Unexpected Medical Bills and Coverage Denials

August 1, 2024

Even with health insurance, many working-age Americans face significant challenges navigating the health care system, including unexpected medical bills and coverage denials for doctor-recommended care, according to a new Commonwealth Fund survey. 

In the past year, close to half (45%) of insured, working-age adults received a medical bill or copayment for a service they thought should have been covered by their insurance, and 17 percent were denied coverage for a doctor-recommended service. The survey also found that: 

• Challenging coverage denials and medical bills often works. 
• Among people who didn’t challenge their billing errors, more than half said they didn’t know they could. 
• Nearly 60 percent of respondents said that coverage denials led to delayed care; nearly half of those said the delay worsened their health. 

The authors noted several areas where policy interventions could improve consumer protection, including enhanced monitoring of claim denials and stronger accountability measures.