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West Virginia Value:
Percentage of adults age 65 and older who reported a time in the past 12 months when they needed to visit a doctor but could not because of cost
West Virginia Rank:
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Percentage of adults age 65 and older who reported a time in the past 12 months when they needed to visit a doctor but could not because of cost
1.6% - 2.5%
2.6% - 2.9%
3.0% - 3.7%
3.8% - 4.3%
4.4% - 6.0%
No Data
US Value: 3.8%
Top State(s): Vermont: 1.6%
Bottom State(s): Louisiana: 6.0%
Definition: Percentage of adults age 65 and older who reported a time in the past 12 months when they needed to visit a doctor but could not because of cost
Data Source and Years(s): U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Behavioral Risk Factor Surveillance System, 2024
Suggested Citation: America's Health Rankings analysis of U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Behavioral Risk Factor Surveillance System, United Health Foundation, AmericasHealthRankings.org, accessed 2026.
The high cost of health care in the United States causes many older adults to forgo necessary medical care. A 2021 survey found that approximately 12% of individuals age 65 and older — about 6.5 million Americans — reported that they or a family member avoided essential medical services in the past year due to cost. Lack of health care access has long been associated with increased preventable hospitalizations, which can lead to worse and more expensive health outcomes.
As people age, health care expenses tend to rise. Although older adults are less likely to have difficulty paying medical bills than younger adults (due in part to Medicare coverage), out-of-pocket health care expenses are nearly twice as high among adults age 65 and older compared with those ages 45-54. Additionally, Medicare does not generally cover dental, vision and hearing services that adults may require more frequently as they age.
According to America’s Health Rankings analysis, the prevalence of avoiding care due to cost is higher among:
A study of adults age 50 and older found that those with low health literacy reported delaying or forgoing needed medical care due to cost more often than those with adequate health literacy.
Policies that improve the coordination of benefits and care between Medicare and Medicaid services should be implemented to better address the needs of low-income adults. With more funding and support from the Centers for Medicare & Medicaid Services and state Medicaid agencies, older adults can benefit from additional guidance as they transition to different coverage options at age 65. Many eligible older adults don’t enroll in the programs they qualify for, such as dual Medicare-Medicaid coverage, cost-sharing assistance programs or prescription drug cost-sharing assistance — emphasizing the need for outreach and education about benefits and eligibility during this critical transition period.
The Program of All-Inclusive Care for the Elderly (PACE) integrates health care and social services for eligible seniors, offering an alternative to nursing homes or other care facilities. PACE allows voluntary enrollment for individuals who meet the criteria, providing comprehensive benefits that cover all Medicare and Medicaid services along with other services recommended by health professionals.
Because a lack of health literacy is associated with avoiding care due to cost, efforts to improve health information and services for older adults could also have a positive impact. The Office of Disease Prevention and Health Promotion offers tools and resources to improve health literacy.
Healthy People 2030 has an objective to reduce the proportion of people who cannot get medical care when needed.
Cohen, Robin, and Amy Cha. Problems Paying Medical Bills: United States, 2021. National Health Statistics Reports No. 180. Hyattsville, MD: National Center for Health Statistics, January 18, 2023. https://doi.org/10.15620/cdc:122191.
Levy, Helen, and Alex Janke. “Health Literacy and Access to Care.” Journal of Health Communication 21, no. Suppl. (March 28, 2016): 43–50. https://doi.org/10.1080/10810730.2015.1131776.
Pezzin, Liliana E., Hillary R. Bogner, Jibby E. Kurichi, Pui L. Kwong, Joel E. Streim, Dawei Xie, Ling Na, and Sean Hennessy. “Preventable Hospitalizations, Barriers to Care, and Disability.” Medicine 97, no. 19 (2018). https://doi.org/10.1097/MD.0000000000010691.
Tipirneni, Renuka, and John Z. Ayanian. “Spillover Benefits of Medicaid Expansion for Older Adults With Low Incomes.” JAMA Health Forum 3, no. 6 (June 3, 2022): e221389.https://doi.org/10.1001/jamahealthforum.2022.1389.
America’s Health Rankings builds on the work of the United Health Foundation to draw attention to public health and better understand the health of various populations. Our platform provides relevant information that policymakers, public health officials, advocates and leaders can use to effect change in their communities.
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