Even with health insurance, thousands of Pittsburghers are just one illness or accident away from financial ruin. A 2005 Harvard study showed 50 percent of bankruptcies are linked to medical bills.
Antoinette Woods of Ross Township said it's been a struggle for her family.
"We're always climbing out of a hole," Woods said.
Since the birth of her three children, Woods has had it tough.
Two of children were born with health problems.
Jenevieve is 10 . She has cerebral palsy, the result of a car accident her mother was in when she was pregnant.
Woods said, "I had blunt force trauma. The air bag hit my stomach at five months. She had a bleed on the brain."
Joshua is 7 and he was born with a rare, life- threatening intestinal disorder which prevents him from absorbing nutrients from food.
Woods said, "He can't even drink water, milk, juice or anything. It has to be this sterile water."
Joshua had 8 operations and was hospitalized for the first year of his life.
Now to get the nutrients he needs to stay alive he has to drink a special formula and take multiple supplements.
When he does eat normal food his body purges it, undigested, within minutes.
His body can't absorb the food's nutrients before it's eliminated.
The life-saving formula, water and supplements are expensive, so expensive his parents haven't been able to afford all he needs.
This has impacted his health.
Josh said, "I always have pains. I just don't feel good. I've been having arm pain."
His mom said, "He's getting real bad leg pain because he doesn't have his calcium. He's falling asleep at school and at home because he doesn't get his B-12."
The Woods are a middle class family. Antoinette is a teacher and her husband Doug is a graphic artist.
They have health insurance through his company.
At $200 a month, it is reasonable.
It does cover some of Josh's food, but the family's co-payments for his medical needs are more than $400 a month.
The family has been forced to pay for those supplies with credit cards which are almost maxed out.
Kristen Garrett of Advantage Credit Counseling on the South Side said her company has seen an increase in the number of clients needing help because of medical debt.
Garrett said, "It was 16 percent in 2007 for bankruptcy counseling because of medical bills and 11 percent for credit counseling."
Like the Woods, many people turn to credit cards to help them bridge the gap.
"They may be using their credit cards to supplement their living while putting other money toward medical bills and end up charging things like groceries and gas because they need the basic necessities and don't have enough cash," Garrett said.
Medical debt is a growing problem.
A 2005 Harvard study showed 50 percent of bankruptcies are linked to medical bills.
Most of those bankrupted by illness had medical insurance.
There are a few things people can do to prepare for the possibility of huge medical bills.
Take a closer look your budget. Make sure you know where your money is going.
Do the math.
Consumer Reports explained how to do a "worst case" calculation of your maximum annual costs.
"Add up the total annual cost of your premium, plus your plan's annual out-of-pocket cap. If it's too high, you may want to trade higher premiums for a lower out-of-pocket limit. If you have enough money saved up to cope with an occasional bad year, your trade-off might go the other way."
Look at your policy. Know what is covered.
What if you have a stroke? How many days of physical therapy does your policy allow, are wheelchairs covered?
And start insurance saving as a cushion.
As for Josh, he will not outgrow his health problems. He will always need special food and supplements.
The Woods are afraid without his medical needs met Josh may end up in the hospital.
"He will slip. He will slide down and I'm going to have to put him in Children's because he will need IV fluids and other ways to get what he needs because I can't do it here," Woods said.
And that insurance will cover.
Something that Woods has a hard time accepting.
"For me to come this far with him and have the doors slammed in my face and have no way to fix it, no way to charge it, to get what he needs. Without this food he's going to die."