Confronting a Large Medical Bill? Take Charge with a Plan and These Tips

Receiving a hefty medical bill can be overwhelming, but it’s important to remain calm and take control of the situation. The amount you see on that surprising invoice may not be set in stone. Errors or delayed insurance payments could have inflated the total, and there might be options for financial aid or other forms of assistance to help reduce the burden.

Sometimes, a simple phone call can resolve the issue, while other cases may require additional support.

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Furthermore, debt experts advise patients to approach medical bills strategically. Here are some key steps to follow:

1. Verify the Numbers: Don’t ignore the bill or rush to pay it without understanding the charges. Treat it as a starting point, especially if it’s a substantial amount. Caitlin Donovan, a spokesperson for the nonprofit Patient Advocate Foundation, suggests comparing the bill with your insurer’s explanation of benefits. This document explains how your coverage applies to the care you received and can give you an idea of your potential out-of-pocket expenses based on deductibles or the plan’s limits. If something seems off, contact both your insurer and the hospital for clarification. It’s possible that the hospital made errors when coding the care you received, so request an itemized bill to investigate.

2. Be Aware of the Law: Familiarize yourself with the No Surprises Act, which provides protections for patients. Ensure your care provider complies with this law, which prevents out-of-network providers from billing insured patients higher rates in certain situations. It safeguards patients from excessive bills for emergency care, lab work, or out-of-network specialists when treated at an in-network hospital. If you have questions about whether your bill complies with the law, you can contact the Centers for Medicare and Medicaid Services “No Surprises Help Desk” at (800) 985-3059 or submit a complaint online.

3. Seek External Assistance: Numerous for-profit and nonprofit organizations specialize in helping individuals navigate medical bills. The Patient Advocate Foundation, for example, aided David White in recovering over $2,000 he paid for routine lab work after his kidney transplant. The foundation can provide resources for medical or prescription bill assistance through their online directory. State attorney general’s offices may also have units dedicated to health advocacy or consumer protection. However, exercise caution with medical credit cards offered by providers, as they may carry high interest rates or unfavorable terms that could harm your financial well-being.

4. Explore Financial Assistance: Once you have verified the accuracy of the bill, consider applying for financial aid. Some hospital systems offer assistance even for individuals with relatively high incomes. Don’t assume you won’t qualify—persist in asking for help and finding out why an application was denied. Mistakes can happen, and the application process may require supporting documentation. Unfortunately, hospitals don’t always effectively communicate available assistance programs, so be proactive in seeking information. If financial aid is unavailable, inquire about potential discounts.

5. Bargain and Budget: After addressing errors, seeking assistance, and exploring discounts, you may still need to address a final invoice. Inquire about setting up a payment plan, as many hospitals offer options with little or no interest. However, before committing to a plan, evaluate your budget to determine a payment amount you can manage. Consider income-based programs that may provide support for rent or utility bills. Caitlin Donovan emphasizes the importance of not agreeing to a monthly bill that is too high, as it may result in the debt being sent to collections if you can’t keep up with payments.

Remember, taking an active approach can significantly alleviate the burden of a large medical bill. Stay informed, advocate for yourself, and explore available resources to manage the situation effectively.

The Big Big News Health and Science Department is supported by the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

Frequently Asked Questions (FAQs) about medical bill assistance

More about medical bill assistance

• Patient Advocate Foundation – A nonprofit organization that provides resources and assistance for patients dealing with medical bills and insurance problems.
• No Surprises Act – Information about the No Surprises Act, its provisions, and how it protects patients from unexpected medical bills.
• Consumer Financial Protection Bureau – The official website of the Consumer Financial Protection Bureau, which offers resources and information on managing medical debt and dealing with financial challenges.
• Centers for Medicare and Medicaid Services – The official website of CMS, where you can find information on healthcare coverage, regulations, and resources for addressing medical billing issues.
• Economic Action Maryland – A nonprofit organization in Maryland that assists individuals in applying for financial assistance programs, including medical bill help.
• Howard Hughes Medical Institute – The Howard Hughes Medical Institute’s website, which supports the Big Big News Health and Science Department, focusing on health and science journalism.