If you’ve ever received a medical bill you didn’t understand, you’re in good company. Medical billing can be extremely complicated. And as healthcare costs continue to rise, more and more Americans are faced with medical debt.
Don’t let financial worries keep you from going to a doctor for the care you need, especially if you have a serious or ongoing condition. In this article we’ll look at basic strategies to help you pay off medical bills.
Here’s what we’re going to cover:
- Get insured
- Ask questions
- Watch for billing errors
- Appeal a decision
- Negotiate a payment plan
- Request financial assistance
- Hire an advocate
- Using a personal loan to pay medical bills
- Take charge of your health
Key takeaways: Paying off medical bills
- Good insurance is the single biggest factor in bringing down your medical costs.
- You have the right to dispute any medical bill or insurance decision you believe is incorrect.
- Many healthcare providers have programs to help low-income patients pay for services. Hiring a medical billing advocate is another option.
Get insured
If you don’t yet have health insurance, apply for it now. Good insurance is the single biggest factor in bringing down your medical costs. The Affordable Care Act of 2010 provides low-cost coverage throughout the country; check with the Health Insurance Marketplace to see what plans are available in your area.
Those age 65 and up are eligible for Medicare, a government-sponsored program that covers many, though not all, medical costs for older adults. If you haven’t already done so, you can apply for Medicare here.
Ask questions
Before any major medical procedure, ask your provider for an estimate of your out-of-pocket costs. Check with your insurance company as well to make sure your operation, treatment, or prescription drugs will be covered by your plan. Try to get this information in writing.
If the recommended care is not covered by your insurance plan, ask your doctor or healthcare provider about other options. Generic drugs, for example, may be covered when higher-priced brand-name drugs are not.
Watch for billing errors
Some sources estimate that as many as 80 percent of hospital bills may contain errors. These overcharges are usually due to the complexity of medical billing codes.
When you get any medical bill, first check to see that you actually received all the services listed, and that you haven’t been charged twice for the same service. Compare your bill with the Explanation of Benefits (EOB) issued by your insurance company to make sure they match. If you had to stay overnight in a hospital, verify the dates of your
stay. Don’t pay a medical bill until you’ve received the related EOB and are satisfied that the charges are accurate.
What is an EOB?EOB stands for Explanation of Benefits. Your insurer should issue you an EOB after you receive medical services. It will list the provider, services, date(s) of service, and charges. The EOB will also tell you how much is covered under your insurance plan and how much you may have to pay yourself.Be sure to keep all EOBs for at least a year after the date of service.
Remember that you have the right to dispute any medical bill you believe is incorrect.
Appeal a decision
Insurance companies also make mistakes. If the bill is accurate but you’re told that your care is not covered, you can file an appeal to have the insurance decision reviewed. You are entitled to appeals with both your insurance company and your state’s insurance regulator. Be sure to keep written records of all communications.
There are many U.S. laws designed to protect consumers from unfair or incorrect medical charges. The No Surprises Act of 2022, for example, can help if you received emergency care at a facility that is out of network for your insurance plan.
If you are covered by Medicare, your state’s health insurance assistance program (SHIP) is another resource. SHIPs can explain Medicare decisions and guide you through making an appeal.
Negotiate a payment plan
Even if your insurance appeal is denied, don’t give up. Some providers will allow you to pay off your medical bills in smaller installments, much like repaying a loan. You can try negotiating directly with the billing department to come up with a payment plan that works for you.
Request financial assistance
Many hospitals and clinics have programs to help low-income patients pay for services that are medically necessary. Check to see what options are available at the facility where you received care. If you qualify, your bill could be reduced or forgiven. You may have to provide proof of income and an explanation of your financial hardship.
Hire an advocate
Dealing with paperwork and bureaucracy can feel overwhelming, especially if you’re in poor health. Fortunately, there are now medical billing advocates who can act for you. These professionals are trained to understand, explain, and deal with healthcare charges. They can help with billing questions, insurance claims, appeals, payment plans, and debt forgiveness.
You may have to pay for this service, but a medical advocate could significantly reduce the amount you owe to healthcare providers, especially if your bills are very high. Having someone knowledgeable handle the process for you can contribute to your peace of mind and allow you to focus on getting well. A medical advocate can also relieve your stress by offering emotional support at a difficult time.
Take charge of your health
Don’t let medical debt prevent you from getting the care you need. Keep written records, be persistent, and ask for help paying off what you owe. Remember that bills are negotiable, but health is not.
Using a personal loan to pay medical bills
Personal loans can be used for all kinds of personal expenses, including prescriptions, appointments, and other medical care you’d receive from a doctor. A personal loan could be useful if you need extra funds now and time to repay it.
Oportun: Affordable lending options designed with you in mind
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- Personal loans
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- Set & Save
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Sources:
Consumer Financial Protection Bureau. CFPB finalizes rule to remove medical bills from credit reports
Becker’s Hospital Review. Medical billing errors growing, says Medical Billing Advocates of America
Patient Rights Advocate. How to fight medical bill overcharges
HealthCare.gov. Appealing a health plan decision
CMS.gov. The No Surprises Act protects people from unexpected medical bills
SHIP. Navigating Medicare
Consumer Financial Protection Bureau. What should I do if I can’t pay a medical bill?
Dollar For. Medical bill forgiveness
Experian. When do you need a medical billing advocate?
