In addition to the physical, emotional and mental costs of rape, many survivors in the U.S. are shouldering the financial burden as well.

A new study published in the American Journal of Public Health analyzed hospital billing records for 1,335 privately insured women who were raped in 2013. On average, those women paid roughly 14% of the total cost of treatment, which doesn’t sound too steep — except it translates to an average of $948. Insurance companies paid an average of $5,789.

“With other violent crimes, victims are not responsible for paying for the damage that results from the crime,” Ashley Tennessee, the study’s lead author and an assistant professor in the Medical University of South Carolina’s Division of Healthcare studies, told Reuters Health. “Many people know sexual assault is an issue, but they’re often unaware that victims have to pay for associated medical charges.”

The 1994 Violence Against Women Act, most recently renewed in 2013, is supposed to shield rape victims from the costs of medical care. It requires states to pay for forensic exams — also called rape kits — but doesn’t address the other services patients often receive in the wake of sexual assault.

According to Reuters, 98% of the women in the study were not hospitalized and paid an average of $316 for outpatient services, while a hospital admission translated to an average out-of-pocket cost of $788. About 63% continued accruing costs in the month after their hospital visit, paying for things like prescription drugs — pain medication, Plan B, HIV prevention medication, antibiotics, drugs to ease anxiety, etc. — mental health care and residual medical treatment.

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