Having insurance coverage does not necessarily solve all medical financial problems.[@@]

About 35% of U.S. adults who had health coverage all year around in 2003 said they had problems with medical bills or medical debt that year, according to a report released today by The Commonwealth Fund, New York.

A team of Commonwealth Fund researchers led by Michelle Doty based the report on a survey of 4,052 U.S. adults age 19 and over conducted from September 2003 to January 2004.

Working-age adults incur significantly higher rates of medical bills and debt problems than those over 65, the researchers write.

“Even working-age adults who are continually insured have problems paying their medical bills and incur medical debt,” the researchers write in the survey report.

Insured adults with high deductibles, tight coverage limits and plans with relatively narrow lists of covered services were more likely than other insured survey participants to face medical financial problems.

Many of the insured survey participants had deductibles under $500. Those participants did not receive enough care to exceed coverage limits for treatment of specific illnesses or injuries, and their plans covered all of the care that the participants expected the plans to cover. Fewer than 33% of those insureds reported suffering medical financial problems.

But the share facing serious medical financial problems was 49% for patients with deductibles over $500, 61% for patients whose plans failed to cover all of the care that the patients expected them cover, and 65% for patients who reached the coverage limits for treatment of specific illnesses and injuries.

“Having less comprehensive benefits when insured [remains] a significant predictor of medical bill problems and medical debt,” the researchers write.

About 10% of the survey participants who had health coverage all year round said they had to change their way of life significantly to pay medical bills, the researchers write.