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New data from The Harris Poll for Nationwide reveals a troubling paradox in American healthcare: while most have insurance, many cannot afford to actually use it. Rising medical costs are prompting even insured individuals to make difficult choices about their health, with two in five reporting they have avoided seeking care when sick due to cost concerns. This isn’t a minor issue, as 41% of respondents admitted to skipping healthcare appointments altogether in the past year. For insurers, employers, and financial advisors, this trend presents a clear and urgent opportunity to earn trust by protecting access to care, improving cost visibility, and helping households better plan for their long-term health expenses.
The Dangerous Trade-Off: Preventive Care Is Being Pushed Aside
This pressure is coming from two directions, as rising premiums and high out-of-pocket obligations combine to squeeze household budgets. With average premiums on track to rise 5-6% in 2025 and temporary Affordable Care Act tax credits set to expire, many families may face an even steeper financial cliff. The strain is already evident in day-to-day finances, where 31% of Americans say they cannot afford an unexpected $500 medical bill and 18% have resorted to medical debt or credit cards to cover out-of-pocket costs. Exacerbating this further, the high cost of new medications, such as GLP-1 drugs, adds another layer of financial pressure when insurance coverage is limited.
The Financial Squeeze: A Two-Sided Cost Burden
This pressure is coming from two directions, as rising premiums and high out-of-pocket obligations combine to squeeze household budgets. With average premiums on track to rise 5-6% in 2025 and temporary Affordable Care Act tax credits set to expire, many families may face an even steeper financial cliff. The strain is already evident in day-to-day finances, where 31% of Americans say they cannot afford an unexpected $500 medical bill and 18% have resorted to medical debt or credit cards to cover out-of-pocket costs. Exacerbating this further, the high cost of new medications, such as GLP-1 drugs, adds another layer of financial pressure when insurance coverage is limited.
A Looming Crisis: How Health Costs Are Derailing Retirement Security
The anxieties of today are casting a long shadow over tomorrow, with health and wealth converging into a primary source of retirement fear. A staggering 73% of Americans list out-of-control healthcare expenses as a top concern for their retirement years, and 71% are terrified of what those costs could do to their savings. For many, this isn’t a hypothetical fear; more than half (51%) report that medical expenses have already drastically reduced what they have saved or will be able to save, while 68% worry a single major health event could derail their financial future for years.
This widespread concern is compounded by a troubling lack of preparation. A majority of Americans feel unequipped for the road ahead, with 59% not confident in their ability to budget for healthcare in retirement and 66% unable to even estimate their lifetime costs. It’s no surprise, then, that only 38% have a dedicated plan to save for what they expect to need. This readiness gap is worsened by significant knowledge gaps around Medicare, where a recent quiz showed respondents getting only about half the answers correct and 66% incorrectly believing, or not being sure, that Medicare covers long-term care.
What Brands Can Do
- Financial Advisors and Wealth Platforms: Make healthcare a core line item in plans. Model premiums, out-of-pocket scenarios, and high-cost drug exposure. Guide HSA contributions, build reserves for $500 to $1,000 shocks, and provide clear Medicare filing and coverage education.
- Employers and Benefits Leaders: Reduce barriers to prevention with low or no cost primary, dental, vision, and mental health visits. Offer price transparency tools, in-network navigation, and targeted support for chronic conditions. Communicate changes early, including any impact from expiring subsidies.
- Health Plans and Providers: Proactively identify members who are delaying care and offer outreach, flexible scheduling, and payment plans. Clarify coverage criteria for GLP-1 and other high-cost therapies, and highlight lower-cost alternatives where clinically appropriate.
About the research
The research was conducted online in the United States by The Harris Poll on behalf of Nationwide among 1603 US adults aged 18+, including 400 Gen Z (18-28), 400 Millennials (29-44), 403 Gen X (45-60), and 400 Boomers+ (61+), with additional oversamples for a total of 503 Black or African American adults, 506 Hispanic adults, 405 adults aged 60-65, 510 Chinese adults, and 507 Asian Indian adults. The survey was conducted 9/17/2025-10/21/2025.
Learn more about the Nationwide Retirement Institute and additional consumer planning behaviors.
