(Bloomberg) -- More than a third of US military veterans under age 65 have concerns about their ability to pay medical bills, whether they get their coverage from private or government programs, according to a survey.

About 13% of veterans had problems paying medical bills and over 8% had forgone medical care altogether, according to the report from the National Center for Health Statistics. Those covered by private insurance were more likely to be worried about health costs than people who got care through the US Department of Veterans Affairs or the Department of Defense’s Tricare program, the report found. 

“For some people, that may be a surprising result that may be counterintuitive,” said Robin Cohen, an NCHS statistician who helped write the study. 

Veterans’ health has been a continuing source of controversy after critics charged in 2014 that some VA enrollees were unable to get timely appointments and attention for a variety of conditions. A February report from the Government Accountability Office, the investigative arm of Congress, found that although the VA health system had made progress, it still needs to address areas including caring for disabilities and securing patient data. Yet the study from NCHS, a division of the Centers for Disease Control and Prevention, indicated that despite its shortcomings, the government health programs appear to shield veterans from financial worries. 

US adults with private health insurance coverage were less likely to be in families with issues paying medical bills than adults in other government health programs like Medicaid or Medicare, the study noted. The percentage of veterans using Tricare and VA health-care more than doubled from 2000 to 2016, while reliance on private insurance dropped by about 16 percentage points over that same time period.

Health care for veterans works differently than the broader US health-care system. For example, the Veterans Health Administration isn’t like insurers that reimburse providers for a patient’s health-care costs. Instead, it runs medical centers and employs its own clinicians. 

Veterans who get benefits from the VA also don’t pay premiums or deductibles for VA care, though they may need to be responsible for co-pays. Tricare, meanwhile, is for uniformed service members, retirees and their families, and its plans generally have deductibles and co-pays.

More than 9 million veterans are enrolled in VA health care, but some still prefer to use other providers, citing easier access to care and more timely appointments, according to the Wounded Warrior Project.

--With assistance from John Tozzi.

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