Part 3: Getting Help with Your Medical Bills
Our primary goal in this guide has been to provide you with as much information as possible in as clear a way as possible to help you lower your exorbitant medical bills yourself.
There’s also the matter of time — spent calling the hospital and insurance company, persistently following up, and trying to clear every hurdle they put in front of you — precious time that you may not have in the course of your day-to-day life.
Fortunately, you don’t have to go it alone. There are a number of resources that can help you navigate the medical billing system and negotiate on your behalf to lower your bill. These include experts trained who may catch things that non-trained people might miss, lowering a bill even further than expected.
And when a reduced bill is still more than you can afford to pay, there are options for financial assistance on what you owe.
In this part, we lay out several possible courses of action should you decide not to negotiate your bill on your own.
Find an Advocate/Negotiator
A Medical Billing Advocate is (usually) an expert on the complexities of the medical payments process and a seasoned negotiator. They can help you better understand the process, and they will demonstrate the persistence, patience, and expertise required to maximize your savings.
In short, advocates provide two major benefits:
- Negotiating Expertise to help you maximize savings
- Peace of Mind to allow you to relax and go about your life
Negotiating a medical bill can be a long and draining process. If you aren’t prepared to take the time to learn or consistently follow through, and if you’re too likely to accept “no” for an answer — an advocate may be a great option. And above all, if you don’t feel comfortable negotiating your medical bill, it may be worthwhile to find an advocate to step in on your behalf.
On the other hand, if you’re the type of person who likes to figure things out on their own, is persistent and patient in the face of a challenge, and don’t mind picking yourself up when you fall down — then this guide may be all you need to negotiate your bill.
When looking for help, consider medical billing advocates who offer free consultations in which to discuss your situation and provide guidance on how best to proceed. The best advocates won’t hold anything back or talk about “secret” processes — they’ll be open and helpful with their advice before leaving it up to you to decide whether or not to hire them for their services.
Here at Resolve Medical Bills, we offer medical billing negotiation services and provide a free no-obligation, 20-minute consultation, during which we’ll review your situation and provide our thoughts on the best strategy forward. After that, it’s entirely up to you whether or not to engage us further.
Find Financial Assistance
Sometimes, even after the best negotiation efforts, medical bills are still too large to pay. Even in this case, there are still a number of options available to you, including:
Hospital Financial Aid
It never hurts to apply for financial aid from the hospital, even if you think you may not qualify. Many hospitals will offer some form of assistance to people whose income is three or four times the federal poverty line. For example, the poverty line for a family of four is around $25,000 in annual household income, which means that a family earning up to $100,000 per year might still qualify for financial aid from the hospital.
Do a Google search for “[hospital name] financial assistance,” and find out what information is available online or who to call to see if you qualify for any assistance.
Your State Medicaid Office
It’s worth performing a Google search to find out if qualify for help from your state Medicaid office. Medicaid eligibility is generally based on income levels, and your state’s office can provide guidance on whether or not you qualify.
Even if your procedure already happened, you may still qualify for “Retroactive Medicaid.” The US government allows for Medicaid coverage up to three months prior to the medical application.
And if you don’t initially qualify for Medicaid, many states have established a “Medically Needy” program. This program allows individuals with high medical expenses to reduce the income used to qualify for Medicaid by the amount they spend on their medical bills. So even if you are just over the qualification line for Medicaid, you may be able to become eligible by beginning to make payments.
If your bill is for a child, you may qualify for your state’s CHIP. At the above link, you can find qualification information, enrollment instructions, as well as a number to call to speak to someone about qualifying.
Many pharmaceutical companies provide assistance programs for those with financial need to help pay for their drugs — since some of those drugs can be extremely expensive, financial need can be very loosely defined.
If your medical bill involves a particularly expensive drug, reach out to the pharmaceutical company that manufactures the drug and ask if they offer any grant programs to offset its cost.
Medical Bill Charity Programs
A quick Google search for “medical bill charity for [treatment you received]” will show you a number of charities that can help you with your medical bill. Here are just a few we turned up:
- PanFoundation focuses on helping people with life-threatening, rare, and chronic diseases
- Healthwell Foundation helps the underinsured pay for medical care
- Leukemia & Lymphoma Society lends support to those suffering from leukemia or lymphoma
- CancerCare is a charity to help people pay for cancer treatment
While there’s no guarantee that you’ll be able to get covered by these charities (and many have their own unique eligibility requirements), it never hurts to call them up and ask about help.
GoFundMe can be a great way to engage friends, family, and your community for help in paying off your medical expenses. In fact, GoFundMe itself claims that over 250,000 medical campaigns are posted per year (with over $650 million raised from those campaigns). That’s a lot of money raised, and something that can be incredibly helpful to paying off your medical bills.
The site even offers tips on how to run successful campaigns.
Take Out a Loan
If all else fails, it may be possible to get a personal loan to pay off your medical bills. But we recommend being very careful and to understand all aspects of the loan, as interest rates can be much higher than car or home loans. And you’ll still be responsible for making monthly payments to pay off the loan — plus interest.
We recommend checking out personal loan companies such as LendingTree, Sofi, Earnest, Upstart, and Prosper (though there are many others), as well as contacting your local bank. Many of these companies are coming out with loans specifically to help pay off medical debt (it’s a sad state of affairs when medical loans are commonplace enough for this to happen), so it may be worth working through with them.
Hospital Payment Plan
If your hospital will place you on a payment plan, this can often be a much better alternative to taking out a loan, as these plans usually are no- or very low-interest, meaning you’ll pay less in the long run.
After you’ve finished reducing your bill (negotiating, removing improper charges, and ensuring insurance covered the right amount), you can call up your hospital’s billing department and ask to be put on a payment plan. The hospital will likely request that you pay an amount up front and then commit to making monthly payments at a low- or no-interest rate.
Ignore Your Bill
A final option is to ignore you bills and hope they go away.
While some people have had success with this, we don’t recommend doing this. The hospital can (and likely will) refer you to a collections agency, or can sue you to force wage garnishment. Either or both of these are not only annoying, they can also hurt your credit (though perhaps not as badly as other kinds of debt can impact your credit).
Will that happen every time? No. We’ve seen people who have simply ignored their medical bills and eventually had them written off by the hospital and/or collections agencies. Even if that does happen, you’ll likely have to deal with a barrage of phone calls and letters about your unpaid debt, and you’re rolling the dice on legal action that the hospital has the right to take.
If you’re interested in understanding this path more in depth, read the statute of limitations on debt collection for your state.
Again, this is not a path that we recommend, do so at your own peril.
When all else fails, bankruptcy may be an option (we say “may” because bankruptcy laws vary from state to state and the viability of this path needs to be evaluated on a case-by-case basis).
The National Association of Consumer Bankruptcy Attorneys (NACBA) offers a great guide on the pros and cons of filing for bankruptcy, how to choose the right attorney, alternatives to bankruptcy, and other useful insights that can help you make a better decision given your unique circumstances.
They also have a “Find an Attorney” tool that lets you search for a bankruptcy attorney near you. Many bankruptcy attorneys offer free consultations to be able to discuss the specifics of your situation and to get a better idea of whether bankruptcy is an option for you.
Don’t declare bankruptcy without first discussing with an attorney licensed to practice in the state you live in. They can guide you on the legal protections that bankruptcy in your state provides and whether or not this is the right course of action for you.
- Understanding and negotiating an exorbitant medical bill is a long and drawn-out process — one that you may not have the time, patience, or energy for. Fortunately, you don’t have to endure the process alone.
- There are a number of alternative paths available to you, including seeking out a Medical Billing Advocate who is an expert in medical billing documents and will negotiate on your behalf.
- When considering a Medical Billing Advocate, make sure they offer free initial consultations to discuss your situation, and look for someone who is transparent about their process.
- Even if you still owe more than you can afford after a successful negotiation process, there are several avenues to get help paying; including financial aid from your hospital, income-based Medicaid assistance, medical bill charity programs, a GoFundMe campaign, or medical loans from a bank.
- Ignoring your medical bill is an option, but you risk being referred to a collections agency or having a lawsuit brought by the hospital to force you to pay.
- Bankruptcy MAY be an option. However, bankruptcy laws vary state by state so the viability of this path is very specific to your case. If you’re thinking about this path, use NACBA’s website to find a lawyer who can provide advice and guidance.
Conclusion to this Guide
Patients are spending over $350 billion a year out of their own pocket for healthcare costs. That’s over a $1,000 for every single person in the U.S., and nearly 70% of this can be avoidable.
Our mission is to make healthcare bills fair. We’re doing that by pulling back the curtain on an opaque system designed to make it as difficult as possible to lower patient out-of-pocket costs and get a fair rate. And our sincerest hope is that the resources in this guide help you to better understand your medical bills, recognize when there are items that can or should be corrected, and go about correcting them.
In Part 1: Understanding Your Medical Bills we reviewed the 3 causes of excessive out-of-pocket costs – hospital price inflation, incorrect denied insurance claims, and hospital billing “errors”(i.e. being charged for the same service multiple times, or “mistakenly” being charged for a service not provided).
But these costs are not always easy to spot, because hospital bills and your insurance Explanation of Benefits (EOB) are designed to be confusing and difficult to decipher.
So we reviewed how hospital bills and EOBs are laid out, and the tricks that hospitals sometimes use to disguise the actual rates.
When you receive your hospital, you should never pay the full Billed Charges. That’s what we call the “sucker” rate.
And if you have insurance, make sure you’re paying only the Allowed Amount.
Collecting, organizing, and gaining a detailed understanding of your hospital bill and EOB is the first key step toward reducing your bill to a fair price.
In Part 2: Negotiating Your Medical Bills, we talked about identifying, understanding, and fixing the (potential) particular issue with your bill: Price Inflation, Insurance Denial, Balance Billing, and Billing Error.
Price Inflation is the hospital charging an exorbitant rate for their services — a rate that far exceeds their costs or the amount that an insurance company is willing to pay. This usually occurs when you don’t have insurance, and it can be solved by negotiating directly with the hospital.
Insurance companies all too frequently deny claims that they should have covered. Patience, persistence, and a focus on the details is required to successfully appeal an incorrectly denied claim.
Balance billing occurs when the hospital bills you for the difference between what the insurance company pays and what their standard charges are. Many states are taking a stand against this by passing laws to make it illegal.
As many as 70% of hospital bills have billing errors on them. While these can be hard to detect, it’s important to comb through your bills to identify and correct potential billing errors.
Negotiating isn’t easy, and it isn’t for everyone. The process is strenuous and demands tremendous patience and persistence.
If you doubt your ability to stick with negotiating (over days and possibly weeks), or if you think your case is more complex than this Guide has laid out for you, it might be time to seek some help. You don’t have to do this alone.
In Part 3: Getting Help with Your Medical Bills, we talked about how to get help with your hospital bill, including finding an expert, getting financial help, and other alternatives.
Medical billing advocates are trained professionals with experience auditing bills, negotiating prices, and navigating the process.
Sometimes, even a successfully reduced bill may still be too large. Additional help in the form of financial aid from the hospital, Medicaid assistance, charity programs, or a GoFundMe campaign, or medical loans can help you pay.
Ignoring your bill and declaring bankruptcy may be options. However, it’s important for you to discuss in depth with a lawyer before going down this path, as they can better advise you on the legal protections and ramifications specific to your case.
If you would like to discuss your individual case more in depth, contact us for a FREE 20-minute consultation with one of our representatives. Call 1-877-245-4244, or ask any questions you have about your bills through our online form.