b'Standing by Our Commitment to Assist Those in NeedAs millions of Americans struggled to access medical care, HealthWell continued to stand by its commitment to ensure that no one goes without life-changing, sometimes life-saving, medical treatments because they cannot afford them. Staggering statistics highlight the importance of our work and the critical need for our services, especially for patients living with chronic illnesses and patients on Medicare. Out-of-pocket (OOP) health care costs continued to chip away at Americans health and financial security in 2019. Plans with annual deductibles of $3,000, $5,000 or even $10,000 are now common. 1For many, these costs are simply unbearable. A quarter of adults in the U.S. report difficulty affording their insurance premiums and deductibles, and a similar percentage report difficulty paying for doctor copays and prescription drugs. In fact, health care costs top the list of household expenses the public worries about affording, with 12 percent admitting that medical bills have a major impact on their family. 2When Treatment Costs are Out of Reach 1 https://khn.org/news/high-deductible-plans- 3 in 10 adults report not taking medicines as prescribed because of cost. 2 jeopardize-financial-health-of-patients-and-rural-hospitals/?utm_campaign=KHN%3A%20 1 in 8 adults say their medical condition got worse because they delayed care or reliedTopic-based&utm_source=hs_email&utm_on alternative treatments due to cost. 2 medium=email&utm_content=82299708&_hsenc=p2ANqtzb02_gi1PHTeIp8hqmNBxw7K-Ydy Cancer patients in Medicare Part D are five times more likely to abandon their3VR6y0OxDHmt55NCkmdF2zyzhEVgwiDA4vAMMmthOT3dwLjk8Nniue0bzHFyfJHg&_treatment when they face high cost-sharing. 3 hsmi=82299708 41% of breast cancer patients skipped medication or treatment to save money. 4 2 https://www.kff.org/health-costs/issue-brief/data-note-americans-challenges-health-care-costs/ Cancer patients who go bankrupt are 80% more likely to die from the disease than3 https://www.lls.org/policy-advocacy/cost-of-cancer-careother cancer patients. 5 4 https://health.usnews.com/health-care/patient-advice/articles/2018-02-23/whats-the-financial-cost-of-breast-Chronic Conditions Compound the Problem cancer5 https://www.aarp.org/money/credit-loans-debt/info- 35% of those taking 4 or more prescription drugs report difficulty in affording them. 6 2018/the-high-cost-of-cancer-treatment.html 13.2% of people with diabetes do not take medications as prescribed to reduce costs. 7 6 https://www.kff.org/health-costs/issue-brief/data-note-americans-challenges-health-care-costs/ Cancer patients are 2.5 times more likely than healthy people to declare bankruptcy. 8 7 https://www.cdc.gov/nchs/data/databriefs/db349-h.pdf8 https://www.aarp.org/money/credit-loans-debt/info-Out-of-Pocket Costs for Cancer Care Average Thousands a Year 2018/the-high-cost-of-cancer-treatment.html Acute leukemia patients average $5,147 in OOP costs in the first year following9 https://us.milliman.com/en/insight/the-cost-burden-of-blood-cancer-carediagnosis. 9 10 https://www.fightcancer.org/policy-resources/costs- Multiple myeloma patients incur $9,127 in OOP costs over 3 years. 9 11 cancer https://www.kff.org/health-costs/issue-brief/data-note- Stage I breast cancer patients face average OOP costs of $5,819-$10,114 a year. 10 americans-challenges-health-care-costs/12 https://www.medicareallies.com/senior-insurance-blog/ Stage II colorectal cancer patients face average OOP costs of $5,748-$10,114 a year. 10 does-medicare-cover-cancer-costs Stage IV lung cancer patients face average OOP costs of $5,654-$10,114 per year. 10 13 https://www.commonwealthfund.org/publications/issue-briefs/2019/nov/medicare-spending-trends-2010-2016-increase-prescription-drugOlder Americans Vulnerable in Retirement 14 https://www.kff.org/medicare/issue-brief/ 23% of those 65 and older with Medicare report difficulty affording theirhow-much-do-medicare-beneficiaries-spend-out-of-prescriptions. 11 pocket-on-health-care/ 62% of cancer-related costs are not covered by Medicare. 12 Medicare beneficiaries spend an average of $3,896 a year on drugs. 13 Medicare beneficiaries spend 12% of their income on OOP health costs. 14HEALTHWELL FOUNDATION 2019 ANNUAL REPORT PAGE 3'