Healthcare Costs

Healthcare Costs

Understanding and reducing healthcare costs, medical bills, HSA and FSA accounts, prescription savings, and financial planning for medical expenses.

The United States spends $5.3 trillion on healthcare annually, about $15,474 per person. That's 18% of the entire economy. For individuals, the burden is just as real: four in ten adults carry some form of medical debt, and half say they couldn't handle an unexpected $500 medical bill without borrowing.

This section covers the tools and strategies that actually help: HSAs, FSAs, prescription discount programs, bill negotiation, financial assistance at hospitals, and your rights under the No Surprises Act. Data comes from the CMS National Health Expenditure data, the IRS, and the CFPB.

Tax-Advantaged Savings

Health Savings Accounts and Flexible Spending Accounts let you pay for medical expenses with pre-tax dollars. HSAs offer a triple tax benefit and roll over forever. FSAs are use-it-or-lose-it but work with any plan. For 2026, HSA limits are $4,400 individual and $8,750 family. FSA limit is $3,400. We compare both and cover which eligible items you can buy.

Medical Bills and Debt

Americans owe at least $220 billion in medical debt. If you get a bill you can't pay, you have options: 93% of people who negotiate get a reduction. Nonprofit hospitals must offer financial assistance. Medical debt doesn't hit your credit for 365 days. We cover the full timeline from bill to collections, your rights under federal law, and step-by-step negotiation tactics.

Prescription Savings

Prescription drug spending hit $467 billion in 2024. Tools like GoodRx can cut costs up to 80% at retail pharmacies, but they come with trade-offs including privacy concerns (FTC fined GoodRx in 2023) and the fact that purchases don't count toward your insurance deductible. We review the pros, cons, and alternatives.

Articles

cluster

How Much Does an ER Visit Cost Without Insurance?

The average ER visit costs about $2,715 without insurance. Costs vary by state and severity. Here's what drives the bill and how to reduce it.

cluster

Best HSA Accounts Compared

Fidelity and Lively lead in HSA accounts with no monthly fees and strong investment options. Here's how the top providers compare.

cluster

Understanding Your Explanation of Benefits (EOB)

An EOB is not a bill. It shows what was charged, what insurance paid, and what you might owe. Here's how to read one and spot errors.

cluster

How to Negotiate Medical Bills Step by Step

93% of people who negotiate medical bills get at least a partial reduction. Here's how to do it and what to say to the billing department.

cluster

How Does GoodRx Make Money?

GoodRx made $797 million in 2025 by earning fees from pharmacy benefit managers every time you use a coupon. Here's their full business model.

cluster

Medical Debt on Credit Report: What the New Rules Mean

Medical debt under $500 stays off credit reports. Paid collections are removed. The CFPB tried to ban all medical debt from reports but lost in court.

cluster

What Happens When a Medical Bill Goes to Collections?

Medical bills in collections don't hit your credit for 365 days. Debts under $500 are excluded. Here's the full timeline and your rights.

cluster

Can You Use GoodRx With Insurance?

You can't stack GoodRx on top of your insurance copay at the pharmacy. But sometimes GoodRx is cheaper than your copay. Here's when to use which.

cluster

What Happens If You Don't Pay a Hospital Bill?

Hospital bills follow the same path as other medical debt but nonprofit hospitals must offer financial assistance. Here's the process and your options.

cluster

FSA Eligible Items: What Can You Buy?

FSA funds cover copays, prescriptions, OTC drugs, dental, vision, and more. Here's what qualifies and what doesn't under IRS rules.

cluster

HSA Contribution Limits 2025 and 2026

HSA limits for 2025: $4,300 individual, $8,550 family. For 2026: $4,400 and $8,750. Plus $1,000 catch-up if you're 55 or older.

cluster

HSA vs FSA: What's the Difference?

HSAs roll over forever and require an HDHP. FSAs are use-it-or-lose-it but work with any plan. Here's a side-by-side comparison with 2026 limits.

cluster

What Happens If You Don't Pay a Medical Bill?

Unpaid medical bills go to collections after 90 to 180 days but don't hit your credit for a year. Here's what happens at each stage and what to do.

pillar

The Real Cost of Healthcare in America and How to Save

The U.S. spends $5.3 trillion on healthcare annually. Here's where the money goes, why it costs so much, and what you can do about your own bills.

cluster

Surprise Medical Bills: Your Rights Under the No Surprises Act

The No Surprises Act bans surprise bills for emergency care and out-of-network providers at in-network facilities. Here's what it covers.

money-page

Is GoodRx Worth It? Pros, Cons and Alternatives

GoodRx saves money on prescriptions but has privacy issues and isn't always the cheapest option. Here's an honest look at the pros and cons.

Research Archive

Original research from the Center for Studying Health System Change

Consumers Face Higher Costs As Health Plans Seek to Control Drug Spending

Originally published November 2001

Patient Cost Sharing: How Much is Too Much?

Originally published December 2003

Financial Pressures Continue to Plague Hospitals

Originally published August 2005

Primary Care Workforce Shortages: Nurse Practitioner Scope-of-Practice Laws and Payment Policies

Originally published February 2013

Tracking Health Care Costs: Trends Slow in First Half of 2003

Originally published June 2003

Financial Woes and Contract Disputes Disrupt Market

Originally published June 1997

Episode-Based Payments: Charting a Course for Health Care Payment Reform

Originally published January 2010

Patient Cost Sharing: Promises and Pitfalls

Originally published January 2005

Health Care Costs:

Originally published November 1999

Tracking Health Care Costs: Trends Turn Downward in 2003

Originally published June 2004

Health Care Cost and Access Challenges Persist: Initial Findings from HSC's 2007 Site Visits

Originally published October 1980

Health Care Cost and Access Challenges Persist

Originally published October 2007

Distorted Payment System Undermines Business Case for Health Quality and Efficiency Gains

Originally published July 2007

Tracking Health Care Costs: Spending Growth Remains Stable at High Rate in 2005

Originally published October 2006

General Hospitals, Specialty Hospitals and Financially Vulnerable Patients

Originally published April 2009

Back To The Future? New Cost and Access Challenges Emerge

Originally published January 2001

Do Specialty Hospitals Promote Price Competition?

Originally published January 2006

Seattle Hospital Competition Heats Up, Raising Cost Concerns

Originally published December 2010

Health Status and Hospital Prices Key to Regional Variation in Private Health Care Spending

Originally published February 2012

Tracking Health Care Costs:

Originally published June 1997

Initial Findings from HSC's 2005 Site Visits: Stage Set for Growing Health Care Cost and Access Problems

Originally published August 2005

Emergency Department Diversions: Hospital and Community Strategies Alleviate the Crisis

Originally published March 2004

Little Rock Providers Vie for Revenues, as High Health Care Costs Continue

Originally published July 2005

Tracking Health Care Costs

Originally published September 2002

Tracking Health Care Costs

Originally published December 2003

Continued Hospital Expansions Raise Cost Concerns in Indianapolis

Originally published December 2011

Tracking Health Care Costs: Spending Growth Stabilizes at High Rate in 2004

Originally published June 2005

Aging Plays Limited Role in Health Care Cost Trends

Originally published September 2002

Disease Management: A Leap of Faith to Lower-Cost,Higher-Quality Health Care

Originally published October 2003

Leadership Changes Reinvigorate Cleveland's Health Care Market

Originally published June 2005

Consolidation Continues, Financial Pressures Mount:

Originally published February 2000

Market Developments Signal Cost Hikes in Greenville

Originally published January 2003

High Cost of Medical Care Prompts Consumers to Seek Alternatives

Originally published December 2004

Despite Fears, Costs Rise Only Modestly in 1998

Originally published February 1999

Tracking Health Care Costs: Spending Growth Slowdown Stalls in First Half of 2004

Originally published December 2004

Controlling Health Care Costs

Originally published January 2005

Intense Competition and Rising Costs Dominate Cleveland's Health Care Market

Originally published June 2005

Sacramento: Health Providers Collaborate and Weather Economic Downturn

Originally published December 2012

A Primer on Understanding Health Care Cost Trends:

Originally published February 1999

Patient Cost-Sharing Innovations: Promises and Pitfalls

Originally published January 2004

Getting What We Pay For: Innovations Lacking in Provider Payment Reform for Chronic Disease Care

Originally published June 2008

Tracking Health Care Costs:

Originally published February 1999

Addressing Hospital Pricing Leverage through Regulation: State Rate Setting

Originally published May 2012

Integration Strategies Unravel, Competition Intensifies:

Originally published August 1997

Efficiency and Quality: The Role of Controlling Health Care Cost Growth in Health Care Reform

Originally published January 2005

General Hospitals, Speciality Hospitals and Financially Vulnerable Patients

Originally published June 2008

Highly Consolidated Market Poses Cost Control Challenges

Originally published August 1997

Strong Opinions Held about the Tradeoff Between Choice of Providers and Cost of Care

Originally published March 2000

Health Care Cost Concerns Intensify in Little Rock

Originally published July 2005

Tracking Health Care Costs:

Originally published November 1999