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Rising Medical Costs in COVID-19 Era Threaten Holiday Spending Aflac survey reveals consumers will reduce gift giving in half to adjust to the pandemic-led crisis

COLUMBUS, Ga., Nov. 23, 2020 /PRNewswire/ -- Despite pandemic economic hardships, National Retail Federation forecasting shows consumers will spend just under $1,000 this holiday season — with speculations centering on how Americans have extra cash on hand due to spending more time at home because of the pandemic. However, according to the 2020 Aflac Health Care Issues Survey released by Aflac, a leading provider of supplemental insurance and products in the U.S., the expenses health insurance doesn't cover may make many American families cash in on this so-called "quarantine savings" to pay for out-of-pocket medical costs rather than on holiday gifts for their loved ones.

2020 Aflac Health Care Issues Survey Infographic & Fact Sheet

The second annual national online survey of 1,138 U.S. adults looked at how medical costs over the last two years have affected Americans during the holiday season and year-round, as well as the rate of hospital visits, regrets related to health care coverage decisions and COVID-19's ramifications.

The ongoing rise in health care costs is hitting American families hard, and the challenges posed by the global health crisis are an aggravating factor. Among families with children under 18 in their household who visited the hospital in the past two years, 70% faced significant out-of-pocket medical expenses beyond a copay or deductible during their most recent hospital visit. Of these, 64% said they spent $500 or more in out-of-pocket costs, up from 58% in 2019, and 45% of families said they spent $1,000 or more in out-of-pocket costs, up from 37% last year.

"As a mother of three and a businesswoman, I have seen firsthand how the pandemic has shaped everything from how and where kids learn to how and where employees work," said Stephanie Shields, senior vice president of Broker Sales at Aflac. "In a year ripe with change, one constant remains: High medical costs continue disrupting American families, many of whom may be unprepared for the out-of-pocket expenses health insurance doesn't cover."

Because of these financial difficulties, many families may find it difficult to fill in their loved ones' stockings this holiday season. Within the past two years, nearly 3 in 4 (71%) families said they had to make some sort of sacrifice or hard decision during the holiday season because of medical cost concerns, including:

  • Fewer presents underneath the tree — More than 1 in 5 said they spent less on holiday gifts or went without giving them altogether (23%), decided against purchasing a gift for a loved one (21%) and reduced their overall holiday spending (21%).
  • Risky debt on the rooftop — Nearly one-third (28%) said they relied on a credit card, and 21% borrowed money from a friend or family member.
  • Home alone for the holidays — Over 1 in 5 said they canceled events (23%) and put a stop to travel plans to see family or friends (21%).

In addition, over one-third of families (37%) said they made health care coverage decisions they regret within the past two years. The top reasons for this benefits remorse include choosing a plan with limited benefits (41%), choosing too high of a deductible (40%), going to an out-of-network doctor (39%) and not sufficiently researching benefits (31%).

"It's natural for people to have regrets after making decisions about their medical plan, which can impact their future," said Shields. "While no one could have foreseen what's occurred in 2020, it is essential to learn from the past and educate yourself on the role health care benefits like supplemental insurance can play in helping with the expenses health insurance doesn't cover. Doing so can lead to greater confidence in the coverage you choose and, hopefully, fewer regrets and financial woes, meaning families can focus on getting and staying well."

COVID-19's Impact

At the time of the survey, 16% of families said they or a member of their household was diagnosed with or received treatment for COVID-19, making it the third top health condition among eight prevalent conditions presented that families said they faced. But its impression has been staggering: Compared to the 62% of families surveyed who said they have been to a hospital in the past two years for an outpatient procedure, an overnight stay or both, a full 3 in 4 families who faced COVID-19 said they or someone in their household required hospitalization as a result.

The top-two conditions surveyed families said they have encountered are diabetes (35%) and cancer (16%), with heart attack (14%) and stroke (13%) ranking a close fourth and fifth. According to the Centers for Disease Control and Prevention, each of these conditions is a common comorbidity putting the afflicted at a heightened risk of severe illness from COVID-19.

Interestingly, over 3 in 4 (79%) of those who said they or a household member was diagnosed with or received treatment for COVID-19 also said they faced medical expenses beyond a copay or deductible during their most recent hospital visit. Despite the reason or season, these families have had to make hard choices about their health and finances due to medical costs year-round, including relying on a credit card (44%), postponing seeing a medical professional (37%) or taking a family member to see a medical professional (33%), working extra to offset medical expenses (31%) and taking out a loan (30%).

Perhaps not surprising, for those who said they or a household member was diagnosed with or received treatment for COVID-19, 62% admit coverage regrets within the past two years.

Survey findings for all respondents, not just families with children, are also available and held steady across all groups. Learn more about the financial effects of health care issues and how Aflac can help with the expenses health insurance doesn't cover at

The 2020 Aflac Health Care Issues Survey is a national online survey of 1,138 U.S. adults fielded in August 2020 by Hill+Knowlton Strategies. To learn more about the survey findings, visit

About Aflac Incorporated
Aflac Incorporated (NYSE: AFL) is a Fortune 500 company, helping provide protection to more than 50 million people through its subsidiaries in Japan and the U.S., where it is a leading supplemental insurer by paying cash fast when policyholders get sick or injured. For more than six decades, insurance policies of Aflac Incorporated's subsidiaries have given policyholders the opportunity to focus on recovery, not financial stress. Aflac Life Insurance Japan is the leading provider of medical and cancer insurance in Japan, where it insures 1 in 4 households. Fortune magazine recognized Aflac as one of the 100 Best Companies to Work for in America for 20 consecutive years. For 14 consecutive years, Aflac has been recognized by Ethisphere as one of the World's Most Ethical Companies. In 2020, Fortune included Aflac Incorporated on its list of World's Most Admired Companies for the 19th time, and Bloomberg added Aflac Incorporated to its Gender-Equality Index, which tracks the financial performance of public companies committed to supporting gender equality through policy development, representation and transparency. To learn how to get help with expenses health insurance doesn't cover, get to know us at

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SOURCE Aflac Incorporated