Medical debt is a growing burden among Americans, with more than 1 in 3 U.S. adults carrying a balance, according to a 2021 Healthcare.com survey.

The findings also revealed that more than 6 in 10 adults with overdue bills received care knowing they couldn’t cover the costs, and more than half of balances exceed $1,000.

“There are so many millions of people impacted by medical debt, and it’s a growing problem,” said Jeff Smedsrud, co-founder and president of insurance for HealthCare.com.

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These findings align with a 2021 survey from The Commonwealth Fund showing more than one-third of insured and half of uninsured adults reported a medical bill issue or were paying off healthcare debt.

That’s up from 19% of households carrying medical debt in 2017, according to Census Bureau data.

Moreover, the findings show that many Americans are amassing medical debt despite having health insurance, with patients saying their plans didn’t cover certain services or they used out-of-network providers.

“People don’t realize that even though their specific provider might be in-network, the doctor or anesthesiologist may not,” said Smedsrud. “And that’s not something normally you would think about.”

Indeed, for Americans in large employer plans, 18% of emergency visits had at least one out-of-network charge in 2017, according to a Kaiser Family Foundation report. 

Other common issues for insured Americans were high deductibles or co-insurance, or the percentage of covered services a patient pays.

Despite the high percentages of patients accruing medical debt, the findings show that fewer than half attempt to negotiate the charges. 

“We all negotiate every day,” Smedsrud said. “But there’s a stigma when it comes to medical expenses.”

Patients can ask providers for an itemized bill, check for errors and compare each cost to estimates from websites like Healthcare Bluebook or FAIR Health Consumer.

“Double-check your statement for accuracy and remember you may be able to negotiate a discount,” Smedsrud said.

And some providers may also be willing to set up a payment plan. But it’s critical to respond promptly after receiving a bill, he added. 

“The worst thing you can do is just ignore the correspondence,” Smedsrud said.

HealthCare.com conducted this survey from Oct. 29 to Nov. 1, with 2,852 U.S. adults age 18 and older, balanced across age, gender and U.S. region based on the Census Bureau’s American Community Survey.