A Tough Year

"It's been difficult," says Jacqueline Eyler,56, of Westminster, Md. In addition to recovering from treatment after her 2005 diagnosis of Stage III breast cancer, Eyler this year suffered a small stroke and heart failure, caused by the Herceptin used to treat the cancer. Her husband, James, meanwhile, was treated for Stage I bladder cancer in August.

The more the couple has had to spend in addition to their premiums (those extra costs were $22,000 in 2007, and they are still counting this year's expenses) the less satisfied they have become with their coverage. Their Cigna PPO limits their annual out-of-pocket costs to $5,000 per person on covered services. But out-of-network providers, co-pays on more than two dozen medicines, supplements, Jacqueline's cardiac rehab and some equipment not covered by the plan have cost them much more than that cap.

James's employer will be switching next year from Cigna to an Aetna plan offering less coverage, and "more of the cost will fall on us," Jacqueline says. The couple still is figuring out the financial and medical implications of the switch. "Are my doctors going to be in the network?" she wonders.

In the past three years, the couple has gone through $50,000 in savings to cover health costs, and this year started tapping James's retirement savings. "We don't have any other options," Jacqueline says. They're considering selling their house, but they'd lose money in the depressed market. "It has put a strain on the marriage, for sure," she says.

The Eylers are among the growing group of Americans considered under-insured. A total of 57 million Americans, including 42.5 million with some form of health insurance, faced problems paying for medical bills last year, according to a new study by the Center for Studying Health System Change. That is one in five Americans, up from one in seven in 2003.