WASHINGTON (DC News Now) — Nearly one-third of Americans are burdened by medical debt, according to a recent study, and as new federal data suggests, rural Appalachian states are more likely to face associated financial setbacks.

100 million Americans are burdened by medical debt, according to a new study by the Kaiser Family Foundation. 63 percent of people with these costs have cut back on spending for food and other basic needs.

Last week, the US Consumer Financial Protection Bureau said nearly one in four people living in rural Appalachia have medical debt in collections. All of West Virginia as well as parts of Maryland and Virginia make up the region.

The CFPB indicates people can prepare for expected medical care, consumers should discover what medical services insurance providers do and do not cover, as well as ask health care providers how much procedures will cost.

Hospitals may offer “charity care” for people who cannot afford services–a program that can reduce medical costs or not charge for care at all.

Following medical care, ask for an itemized bill, and see if providers will negotiate the cost, as well as a repayment plan with no interest.

The CFPB added that consumers should ask for a repayment plan in writing that shows monthly statement amounts and an outstanding balance as well as states that their debt will stay with the hospital or doctor’s office if the debt is turned over to a third-party collector.

Good news for consumers came in July when the three nationwide credit reporting agencies indicated unpaid medical bills will not hurt individual credit scores, if consumers cannot afford bills after one year of receiving care.

The National Consumer Law Center has published resources for consumers who have outstanding questions about debt, and the repayment process.