How Can I Get Help with My Medical Bills?

Medically reviewed by Debra Henline Sullivan, PhD, MSN, RN, CNE, COI on November 1, 2016Written by Kimberly Holland on November 1, 2016

Overview

If you need help with your medical bills, you’re not alone. Each year, healthcare rates continue to climb, and with it, millions of Americans are left with hefty bills to cover their costs.

Even with health insurance, medical bill totals can mount. Approximately 20 percent of people with medical insurance have problems with their medical bills. Before you know it, you may be facing a high-priced battle you simply cannot win.

When it comes to wading through medical debt, it’s important to understand how the system works, and how you can work for a better outcome. These tips may help you both avoid expensive medical debt and get out from under it if you find yourself drowning in bills.

Resource list

If you have questions or need advice, these resources may be of help:

  • State human service agencies: These federal or state programs, which include groups like human resource offices, may be able to connect you with local organizations that help reduce medical bill costs or provide reduced-cost counseling. These services should be free, but organizations they connect you with may charge a fee.
  • Veterans’ Affairs: For United States veterans, your local VA office may be able to help you find resources for assistance. They may also be able to help you find medical insurance if you do not currently have it. Assistance is, in most cases, free of charge.
  • Benefits.gov: You may be eligible for federal programs to help with debt. Answer a brief online questionnaire at benefits.gov to find out if you are eligible.
  • Eldercare: If you are a senior or care for someone who is elderly, Eldercare Locator may be able to help you find organizations for medical debt. They may also be able to help find coverage or assistance to prevent future issues.
  • USA.gov: This resources can be used to find organizations, both government and private sector, which can help cover your bills.
  • Healthcare.gov: This resource can help you get health insurance coverage.

First steps

If you’ve received a medical bill you cannot pay, you should take these steps before you sign a check.

  1. Call your insurance company if you have health insurance. Did they refuse to pay? Did an error from the medical provider make them not issue payment? Ask them to clarify why they didn’t pay and what could be done to fix any possible issues so they will cover the expense.
  2. Call your medical provider. Working with the information your insurance company offered, ask your medical provider to correct any errors and refile.
  3. Inspect your bill. Look for errors. It’s possible you have an error on your medical bill. Finding and fixing errors and overcharges may save you a lot of money.
  4. Don’t be afraid to negotiate. Many medical providers will listen to honest offers from clients. Make sure you’re speaking with someone who has the authority to accept changes in rates. Also, be persistent. Keep calling, emailing, or writing until you’ve exhausted all measures.
  5. Seek out help. If these measures aren’t successful, you aren’t out of options. Several agencies and organizations may still be able to help you reduce your medical debt and provide for it.

Understanding medical bills

Most statements from your healthcare provider or your insurance company will include the following categories. Wording may differ between insurance companies and providers, but these are general definitions.

CategoryMeaning
ServiceThis lists the medical service or procedure the doctor or healthcare provider performed.
The provider will also list the price they charge and bill directly to your insurance provider.Discount
Many hospitals, pharmacies, and doctors’ offices negotiate lower rates in order to be a “preferred” provider for insurance companies.Deductible
Before your insurance will begin to pay for your services, you must meet a deductible. In order to meet your deductible, you will pay for services out of pocket until you’ve paid the amount your health insurance contract states you will pay. Once it is met, you pay co-insurance or a co-payment. Your insurance covers the rest.Co-insurance or co-pay
Each time you have a medical service, you are responsible for a portion of that cost to the healthcare provider. Your insurance company will cover the rest.Out-of-pocket maximum
After you meet your deductible, you have another cap. The out-of-pocket maximum is the most you have to pay out of pocket each year. Many out-of-pocket maximums are so high an average family won’t meet them. Once you hit this limit, you will no longer pay any co-insurance or co-payments for the year. Your insurance will cover all of your expenses.
Provider’s responsibilityOnce all the deductions have been taken, your insurance provider will list the amount they will pay for the service you received. If you’ve met your deductible, they will pay their portion and you will pay yours. If you haven’t met your deductible, this is the amount you will typically pay.

Learn more: How do health insurance deductibles work? »

Finding help

Several groups work with the consumer to help sort out medical bills. You may even be able to work with the provider to come up with a payment plan. Below are some of your options.

Patient advocates

Patient advocates people are often part of a law firm. They can be your advocate between the hospital and insurance provider, though they often charge a fee. They can help negotiate your bills, check for errors, and find a solution that is agreeable.

Banks

After you’ve haggled and asked for discounts, you may be able to receive a loan from a bank. The important thing is to find a company you trust.

Ask friends and family members for suggestions, or return to one of the companies you currently use for a loan. Not all banks provide medical loans, but if they don’t, they may have a recommendation for a trustworthy group. You likely will pay fees and interest.

Payment plan

Once you’ve established an amount, ask your medical provider if they will establish a payment plan for you. While you may not be able to pay for the entire cost right now, payments may help you pay your balance over time. Some providers will charge interest or fees for a payment plan.

Understanding your rights

When medical bills mount, it’s easy to feel the situation spiral out of your control. Unpaid medical bills can be reported to your credit score, so any late payments or unpaid bills can impact your credit prospects.

As with any creditor, medical providers can and may seek out payment through collection agencies. You may receive phone calls, letters, and even in-person visits. It’s better to find the help you need and begin the process of climbing out responsibly before the bills do lasting damage.

Outlook

When the bills pile up and the phone keeps ringing, you may feel overwhelmed. The good news is, organizations that help people get out from under medical debt are typically easy to connect with, and they can get you on your way to relief.

Just remember not to settle for “no,” or to stop searching for help if you’re denied at first. It may take effort and perseverance, but most people who need it will be able to find help they need.

Self-Advocacy

In the future, or even now as you continue to need medical care, be your own advocate. Keep these tips in mind:

  • Question services. Your doctor is always looking out for your best care, but before you agree to an expensive test, make sure there isn’t a less expensive option that would be just as useful.
  • Check for prices. Don’t be afraid to call around to local hospitals for pricing. If your preferred hospital is more expensive, ask for a price match from a competitor.
  • Haggle. Many medical providers are happy to discount procedures if they know they will be paid up front, as soon as the procedure is complete. This is especially true if you don’t have insurance. In some cases, you may get extensive discounts for being a quick-paying customer.
CMS Id: 112189