Health insurance in the US is highly variable. Many plans expect consumers to pay a substantial portion of their medical bills. The term "underinsured" tries to capture this segment of the population that is nominally insured but in reality would incur huge bills if they took advantage of their insurance.
And while some people manage to get out of paying their bills by exploiting HIPAA, most just take the massive hit to their credit and walk away from it. So no they don't end up paying that much, but the stress and economic fallout they endure is nothing to wave away either.
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