Medical debt is a significant cause of financial struggle for many people. It can prompt patients and their families to file for bankruptcy, rack up thousands of dollars in credit card debt, use up retirement savings, or even lose their homes. Although high medical bills can be overwhelming—and the complex health care system daunting—you can take steps to reduce your medical debt and its impact on your financial well-being. You should:
Medical providers are often willing to negotiate your bill if you're having trouble paying in full. Ideally, you should contact your medical provider before the account is delinquent or before the collectors start calling.
If you're having trouble paying your medical bills, the first thing you can do is look closely at the charges. The federal General Accounting Office estimates that 99% of all hospital bills contain overcharges. Other experts claim that hospital overcharges average $1,300 per hospital stay. Not surprisingly, experts recommend that you scrutinize each medical bill.
If you don't get an itemized invoice from the doctor or hospital, request one. Then, as you read each line on the bill:
A handful of states have passed laws placing limits on what hospitals can charge for health care services. For example, California's Hospital Fair Pricing Act puts a cap on treatment charges for self-pay patients. Similar laws exist in some other states.
If you find errors on your medical bill or have questions about charges, make an appointment with the doctor or hospital billing office to discuss the situation. Don't hesitate to challenge overcharges, double billing, and anything else that seems unfair.
If you want to negotiate your bill, here are some options to propose:
You can ask for a discount on your medical bill. Many providers spend a great deal of time and effort tracking down folks who don't want to pay. So, when they encounter someone who is at least willing to pay something, they might be happy to make accommodations. If you have a chunk of cash, use Nolo's eForm Offer to Settle Debt With a Reduced Lump Sum Payment, to negotiate a discount on your bill.
Ask if you can pay the bill over time. Some medical providers will accept as little as $50 per month. Some charge interest, some don't. Get all payment terms in writing. If your circumstances change, contact the provider and try to negotiate a different arrangement. Use Nolo's eForm Offer to Pay Debt in Installments.
If you're able, offer to pay a substantial down payment—perhaps 10-25% of the bill—in exchange for a discount on the overall bill.
You might be eligible to receive financial assistance from the government, a nonprofit, or the hospital itself. Check into all three possibilities.
You might qualify for Medicaid, which is a joint federal and state program for low-income individuals and families. Medicaid is set up by the federal government and is administered differently in each state. Although your income must be quite low to qualify, some people with higher incomes can get coverage if their medical bills are comparatively high. Medicaid is best used to reduce future medical bills, but that might enable you to pay your current ones.
Each state has an insurance plan to help cover health care costs for children in lower-income families. Contact your local or state-level social service agency to see if your children qualify.
Some states and local governments have assistance programs for people struggling with high medical bills. Some private nonprofit groups also offer financial assistance to help offset medical expenses. Contact your city or county representative (or local social service agency) for information.
Most hospitals—especially nonprofit facilities—have charity care programs to help cover or reduce medical bills for some families. Eligibility is usually based on income and savings. Advertising for these programs is often minimal or non-existent, so you will need to seek them out actively. Many nonprofit medical clinics have similar programs.
If you have health insurance, but your medical provider is billing you anyway—or your insurer is refusing to cover all or part of a medical bill—take action.
Make sure they have billed your insurance company.
Find out why the bill hasn't been paid.
If the bill is from a hospital, see if the facility has an ombudsman or patient's advocate. Such a person works to help resolve disputes between patients and the hospital. Also, charity care programs sometimes assist uninsured patients who can't afford their medical bills and don't qualify for government aid. But you might need to contact the hospital prior to your medical services and explain your situation.
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