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Dealing With a Big Medical Bill? Things You Should Know

Americans owed at least $88 billion in medical debt as of June 2021. A 2022 study found that one out of five insured adults aged 18 to 64 faced unaffordable out-of-pocket healthcare costs. Consequently, many people must choose to cut spending on food and other necessities, deplete their savings, or forgo further medical treatment. Delinquent medical bills can also contribute to foreclosures and personal bankruptcies.

Key takeaways:

A big medical bill can create dire financial circumstances. However, many people feel stuck and don’t know where to go for help. Here are some ways to deal with or solve looming healthcare debt. Out-of-pocket health expenses, including deductibles, copayments, tests, and medication and procedure costs, often add to massive debt. At least 100 million people carry this burden from medical or dental bills. Deb collectors contact people for medical debt more than any other kind of debt.

Even if you don’t have the resources to pay a hefty medical bill, it is best not to ignore communications from the healthcare provider or medical debt collector. If you cooperate and understand your rights, they may help you find ways to settle the debt in a way that satisfies both of you.

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Appeal the bill

If you are certain that you do not owe the amount on your medical bill, you can make an appeal to the health care provider. It’s important to remain as calm, assured, and cordial as possible in every interaction.

Contact your care provider to learn about their internal appeal process. Be prepared to show any documentation related to the service you received and the bill.

You may also need to communicate with your health insurance company. They might be able to show, for instance, that your treatment was pre-authorized. Ask for a timeline of when to expect a response.

Get an advocate

A medical billing advocate can be your go-between for dealing with doctor or hospital bills. They work with health care providers and insurers to resolve billing disputes or errors and negotiate bill payments.

The Patient Advocate Foundation has a National Financial Resource Directory, which lists local and nationwide resources for addressing medical debt as well.

What happens if you don't pay your medical bill?

If your medical bill goes unpaid, your healthcare provider may assess late fees, interest, or other charges in addition to your total due. They may eventually sell this debt to a third-party debt collector, who will further pursue payment.

A statute of limitations is a limited period creditors or debt collectors can file a lawsuit to collect a debt. Most statutes of limitations last three to six years, but some districts allow more extended periods. Statutes of limitations can vary according to state laws and the type of debt.

Debt collectors may pass along information about delinquent medical debts to credit bureaus. The law requires them to “follow reasonable procedures to assure maximum possible accuracy of the information concerning the individual about whom the report relates.”

Once your bill is in collections

If you still don’t pay your medical bill in collections, the debt collector must wait at least 12 months before reporting the debt to the major credit bureaus. This gives you time to take care of or dispute the debt before it affects your credit score.

Federal laws prohibit debt collectors from harassing people about their unpaid bills. If you ignore their payment calls, the collection agency might file a lawsuit to garnish your wages or place a lien on your home.

If you don’t respond appropriately to a served lawsuit, the court may issue a judgment against you. This might limit your ability to dispute the debt, even if you don’t owe it.

Starting in 2023, unpaid medical bills under $500 will no longer be reported on consumer credit reports. However, those with medical debt appearing on their credit reports earlier may continue to see them.

Verify your charges

The Consumer Financial Protection Bureau’s April 2022 Complaint Bulletin reported that about 15% of debt collection complaints in 2021 involved debts incorrectly assigned. Either the debt was already paid or not owed at all.

Providers can send unpaid accounts to third-party collectors after billing. These companies have limited access to providers’ records, making it difficult for people to confirm that the medical debts are accurate.

Duplicate and unauthorized charges are common, so reviewing billing statements is essential. Ask your health provider’s billing department to explain unfamiliar amounts or medical codes. Also, check your policy’s documents and explanation of benefits forms so you’ll know what services your plan should have covered.

Ask for a discount

Many medical providers will prefer to get less than you owe over getting nothing at all. Some doctor’s offices and hospitals offer a discount for paying your bill within a specific time. They might also arrange a settlement with a No Surprises Help Desk medical bill payment plan to spread out what you owe.

If you are successful with such an agreement, get it in writing before you start making payments.

Find help to pay hospital bill

Some hospitals and managed care organizations offer financial assistance programs for low-income patients. The Affordable Care Act (ACA) requires nonprofit hospitals to provide financial aid, including hospital payment plans, to qualifying patients.

Some states also require hospitals to help patients pay their medical bills. California, Illinois, Maryland, New York, Washington, and other states require reduced fees or free care for people with limited or moderate incomes.

Understand and stand up for your rights

According to a Kaiser Family Foundation survey, 60% of insured adults are unaware of their legal appeal rights regarding medical debt. The federal government has recently enacted laws to provide more affordable healthcare and reduce medical debt.

  • No Surprises Act. The No Surprises Act (NSA), which became effective in 2022, aims to help protect people from surprise medical bills. A surprise medical bill often results from services you unknowingly received out-of-network, such as emergency treatment. The NSA may also make it easier for people to compare prices among healthcare providers. This Act requires providers to give people who self-pay or are uninsured a good faith estimate of costs upfront.
  • Affordable Care Act. The Affordable Care Act (ACA) was designed to make medical services more accessible and affordable. It gives individuals and families the right to choose their health insurance plans, receive preventative care, and get coverage for preexisting conditions.

You are far from alone if you're stuck with a big medical bill. You have the right to check the accuracy of your debt and ask for a discount. In some circumstances, healthcare providers and government agencies may also help you reduce or clear your healthcare debt.

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