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Medical bills can be overwhelming, particularly when you're still dealing with treatment or recovery. However, you may be able to lower your bills, spread out the payments or find someone willing to help. One thing is certain, though: You don't want to set the bills aside thinking there's nothing you can do about them, or assume the bill you receive always reflects what you owe.
Request and Closely Review an Itemized Bill
Medical bills and insurance statements can be confusing to read, but a close analysis could save you money.
Your insurance company may send you an explanation of benefits (EOB), which is an initial report of what your insurance covers—not a bill. You may even get several EOBs for different appointments or procedures. Separately, the health care provider may send you a bill for costs that your insurance doesn't cover, including deductibles or copays. Before you get your bill, you might request a line item estimate of service costs, and if the bill you do get isn't detailed, you can request an itemized bill.
(As an aside, don't ignore EOBs or bills if you haven't received services; that may be a sign that you're a victim of medical identity theft.)
Closely review all the documents for errors, such as double billing, procedures or equipment that weren't done or used, incorrect times for operating rooms, and charges that your insurance should cover. Also, double-check that the EOB matches the bills you receive.
Medical billing is complicated, and mistakes happen. Catching and reporting the mistake to the medical provider's billing department or your insurance company can help you avoid overpaying.
Look for Medical Bill Repayment Plans
Once you've verified the bill is correct, you can contact your health care provider to discuss payment options. Some of these might help you spread out the cost over time or save you money overall.
- Full-payment discount: Some medical providers may offer a discount if you can quickly pay the bill in full. Of course, this isn't an option for everyone, but it may be worth asking if you can afford around 80% or more of the bill.
- Down payment discount: Alternatively, you may be able to get a discount if you can make a large down payment and agree to pay the rest of the bill over time.
- Payment plans: Medical providers may also offer payment plans if you can't afford to pay the bill right now. Sometimes you may even receive a low- or no-interest plan, which could provide significant savings over taking out a loan to pay the bill.
These options are offered by many hospitals and medical groups—49% of providers offer payment plans, according to a survey by HIMSS Analytics—and could come in clutch if you're not sure how you'll pay for your medical services. If you are offered a discount or payment plan, make sure you get the terms in writing and follow the terms of the accommodation closely.
Consider a Medical Billing Advocate
If you're feeling overwhelmed or aren't getting anywhere on your own, you could hire a medical billing advocate to work on your behalf.
The advocate may go through the same process described above—looking over your EOB and bill and discussing payment options with the medical provider. But their experience and expertise may help them quickly spot errors or know which options your provider tends to offer. Advocates can also try to negotiate on your behalf, working to get fees and bills waived or lowered.
Medical billing advocates charge for their services, but they may help you save hundreds or thousands of dollars. Depending on the advocate and situation, you may pay hourly, by project, based on how much you save or a monthly fee (when retaining an advocate for ongoing services).
Ask your employer if it retains medical billing advocates as an employee benefit. If not, it might not make sense to hire an advocate unless you're facing very high bills or a big stack of paperwork you can't manage on your own.
If you're interested in working with an advocate, you can find options from accreditation organizations and directories, such as the Alliance of Claims Assistance Professionals and AdvoConnection. You may want to interview and compare advocates to find one that's familiar with your insurance provider, medical situation and who charges a fee you can afford.
Search for Financial Assistance and Charity Programs
You may qualify for financial assistance from a variety of different programs, including government and nonprofit organizations. Availability and eligibility can vary widely depending on where you live and your condition, but the programs generally focus on helping low- to moderate-income households. Some examples of providers and programs include:
- Medicaid: Jointly funded by federal and state governments, Medicaid coverage is available to low-income adults, children, pregnant women, people over 65 years old and people with disabilities. If you qualify, you may be able to receive free or low-cost medical benefits. Parents may also be able to apply for the Children's Health Insurance Program, which provides medical and dental coverage for uninsured children up to 19 years of age.
- Pharmaceutical companies: Some companies that create and sell prescription drugs and medical supplies have patient assistance programs (PAPs) that may offer you free or low-cost medications. The Medicare website has a search tool that you can use to find PAPs using a prescribed drug's name.
- Health care providers: Some hospitals, clinics and health care providers offer reduced or free care to eligible patients. You may have already come across this if you tried to negotiate a medical bill.
- CancerCare: CancerCare has a copayment assistance foundation that can help with expenses related to specific cancer diagnoses.
- HealthWell Foundation: The HealthWell Foundation runs several disease funds that may help with premiums and copays. You can check the current open funds online.
- Leukemia & Lymphoma Society (LLS): The LLS has several financial assistance programs that may help with travel expenses, copays and urgent needs (including rent, utilities and food).
- Patient Access Network (PAN) Foundation: The PAN Foundation has financial assistance programs that could help you cover out-of-pocket expenses, including health insurance deductibles, premiums and travel. There are almost 70 disease-specific programs available, although they're not all open to new applicants at once.
This is far from an exhaustive list, and you should continue looking for local or state programs, religious groups and other nonprofits that may offer medical bill assistance. You could even ask your medical provider's billing department for suggestions, or reach out to larger assistance programs or foundations and see if they have recommendations.
Look to a Loan as a Last Resort
If you aren't able to get on a low-cost payment plan or find enough help elsewhere, you might consider taking out a loan to pay your medical bills or use a credit card.
Generally, this is a last resort as loans and credit cards (including medical credit cards) carry interest rates and fees that add to your overall costs. You also want to be careful about using a secured loan, such as a home equity loan or line of credit, to pay for medical bills, as they can cause you to lose your property if you fall behind on payments.
There may be a few exceptions, though. For example, if you have good credit and a decent income, you may qualify for a low-rate personal loan. Or, you may be able to get a credit card with an introductory 0% annual percentage rate, allowing you to pay off the debt over time without paying additional interest.
What to Do if Your Medical Debt Is Already in Collections
If you haven't been able to pay a medical bill or keep up with a payment plan, your debt may be sent to a collection agency. The collection amount may legitimately be higher than your original bill due to fees and interest.
Similar to when you're dealing with other accounts in collection, you may want to ask the debt collector for additional information if you believe there may be a mistake. Ideally, you make a request within 30 days of when the debt collector first contacts you—the Consumer Financial Protection Bureau has several sample letters you can use if you're not sure how to start.
If you find errors with the collection account, you can dispute their claim. You can also send disputes to the credit bureaus to get inaccurately reported collection accounts removed from your credit reports.
If there aren't any errors, you could try to pay off the debt or negotiate the amount. The debt collector may give you a discount for a full payment, or offer you a payment plan for a reduced total amount. If you can't come to an agreement, the collector can continue asking you for payment until the debt is repaid or you send a written request asking it to stop contacting you.
But stopping a debt collector from contacting you doesn't absolve the debt. The collection agency can still attempt to collect payment or sue you and get a judgment, allowing it to garnish your paycheck or bank account.
Monitor Your Credit for Medical Collections
Generally, medical bills don't get reported to the credit bureaus unless your account is sent to collections. But even then, medical collections are treated differently from other types of collections. The credit bureaus wait 365 days before allowing unpaid medical debts to appear on credit reports, giving you time to correct errors and sort out payments from your insurance provider. Paid medical collection accounts and accounts under $500 do not appear on your reports or are removed once they are paid.
Additionally, recent versions of common credit scoring models give less weight to unpaid medical collections than other types of collections. After all, unlike some other types of debt, you don't get to choose whether you get sick.
Still, it can be important to monitor your credit reports for unexpected changes, and to check your score before applying for a new loan or credit score. Fortunately, you can get a FICO® Score☉ for free from Experian, along with free Experian credit report monitoring.