Why Even Insured Americans Are Skipping Preventive Care—And What It Costs Them

Rising healthcare costs are pushing even insured Americans to make dangerous trade-offs with their health. Nearly two in five insured adults (37%) report avoiding medical care when sick due to cost concerns, while 41% have skipped healthcare appointments in the past year alone due to rising expenses.

What Types of Preventive Care Are Americans Skipping?

The cuts to preventive care are widespread and concerning. Over the past year, insured Americans have postponed or cancelled essential health services that can catch problems early when they're easier and cheaper to treat:

• Dental Cleanings: 23% of insured Americans skipped routine dental care
• Vision Tests: 20% postponed eye exams that could detect serious conditions
• Specialist Visits: 17% avoided seeing specialists for ongoing health concerns
• Mental Health Care: 16% delayed mental health appointments despite growing need

This trend is particularly troubling because preventive care is designed to identify health concerns early and avoid costly interventions later. The irony is stark: people are paying more for insurance premiums while simultaneously cutting the very services that could save them money in the long run.

How Much Are Healthcare Costs Really Rising?

The financial squeeze is hitting from multiple directions. In 2025, the average cost for single coverage is on track to increase 5%, with family costs rising 6%. Meanwhile, temporary Affordable Care Act tax credits are set to expire, potentially forcing many households to face even steeper premiums.

The financial impact extends beyond premiums. Nearly one-third (31%) of Americans say they cannot afford to pay an unexpected $500 out-of-pocket medical bill, while 18% have already turned to medical debt or credit cards to cover healthcare expenses. The introduction of high-cost medications, including GLP-1 drugs for diabetes and weight management, is adding even more pressure as many adults face steep out-of-pocket costs or limited coverage.

"Today's health care costs are forcing Americans to make difficult decisions about when and how to seek care," said Kristi Rodriguez, senior vice president at Nationwide's Financial Services Marketing. "Those tradeoffs may feel short-term, but they can have lasting consequences—leading to poorer health outcomes that, over time, drive higher medical expenses and greater financial stress in retirement."

What Does This Mean for Long-Term Health and Finances?

The consequences of skipping preventive care extend far beyond immediate savings. Healthcare fears are dominating retirement planning, with 73% of adults listing healthcare expenses going out of control as one of their top retirement fears, and 71% terrified of what those costs could do to their retirement savings.

More than half (51%) say medical expenses have drastically reduced how much they can save for retirement, while 68% worry that a single major health event could ruin their finances for years. Despite these concerns, most Americans remain unprepared: nearly six in 10 (59%) lack confidence in their ability to budget for healthcare expenses in retirement.

The situation is complicated by widespread misconceptions about Medicare coverage. On average, survey respondents answered fewer than half of a 16-question Medicare quiz correctly, with two-thirds incorrectly thinking Medicare covers long-term care costs—a costly gap in retirement planning.

While the Supreme Court recently upheld free preventive care under the Affordable Care Act in a 6-3 ruling, ensuring that approximately 150 million Americans can continue accessing no-cost preventive services, the future of these protections remains uncertain. The ruling preserves coverage for essential services like mammograms, blood pressure screenings, colon cancer screenings, diabetes testing, and HIV prevention, but leaves the system vulnerable to political changes in leadership.