Out-of-pocket expenses voted top barrier to healthcare access

Only 34% of Americans have visited their primary care doctor in the past year.

A new survey of 2,000 U.S. adults examined their biggest barriers to healthcare access.

Out-of-pocket expenses were a major concern, with 53% stating this would impact their decision to not seek medical care if they needed it.

Nearly half (49%) also cited lack of transportation to the facility where they would need care or being unable to afford the ride.

While nearly half (49%) budget for out-of-pocket expenses, there were differences among generations polled. Gen X led the charge in planning for these costs (54%), compared to baby boomers (39%).

Conducted by OnePoll on behalf of Assurance IQ, results also found just over two-thirds (67%) feel knowledgeable about how their health insurance plan works.

Gen X respondents were more likely to share this sentiment (71%), compared to only 48% of Gen Z.

Overall, seven in 10 (72%) are confident they know exactly what is and isn’t covered by their current health insurance plan.

Yet a similar generational disparity was present. Around three in four Gen X survey-takers felt well-informed (78%), while only 53% of Gen Z did.


Out-of-pocket expenses are a major concern for many, according to a new poll which found that 53% said costs would impact their decision to not seek medical care if they needed it.
Out-of-pocket expenses are a major concern for many, according to a new poll which found that 53% said costs would impact their decision to not seek medical care if they needed it.
Getty Images/iStockphoto

Additionally, the data revealed knowledge gaps in people’s understanding of healthcare in the U.S.

Nearly one-third (32%) don’t feel informed about how the American healthcare system works.

While many felt confident they could explain terms such as preventative care (53%) and out-of-pocket (OOP) limit or maximum OOP (48%) to others, respondents were less sure they knew the difference between an FSA and HSA (36%) and what an FSA is (35%).

“Health insurance can be confusing to navigate, and our research shows this is especially true for younger people,” said Kate Long, consumer financial wellness advocate at Assurance IQ. “Many people end up enrolling in a plan where they don’t understand how much they will end up spending. Or a plan that doesn’t cover their unique needs. This can lead them to forgo critical care if it leads to an unexpected expense.”


Only 34% of Americans have visited their primary care doctor in the past year.
Only 34% of Americans have visited their primary care doctor in the past year.
Getty Images/iStockphoto

Nearly half (49%) of people polled said they like the current American healthcare industry, with 43% saying it could use minor changes.

The top three ways to improve it? Encourage more people to use preventative care (41%), increase access to quality insurance coverage (33%) and eliminate the fee-for-service payment system (28%).

“For many, there are barriers to finding quality coverage,” Long added. “Especially for those who don’t receive insurance through an employer. People often don’t know all the options available to them in terms of plans or financial subsidies, so they either go without or select a plan that doesn’t address their needs. Talking to a licensed insurance agent who asks the right questions can make the process much easier.

Top reasons Americans would forgo medical care

  • I couldn’t figure out how much the appointment, treatment or service would cost me out of pocket – 53%
  • I don’t have transportation to the facility where I’d need to get treatment (e.g., the doctor’s office) or can’t afford to pay for transportation – 49%
  • I’m too busy, and I would rather wait until the problem is more urgent – 28%
  • I generally don’t like going to the doctor – 24%