Get a Surprise Medical Bill You Can’t Pay? 6 Resources That Can Help
Written by
Angela Mae
Edited by
Jenna Klaverweiden
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Did you receive a surprise medical bill? If so, you’re not alone. According to KFF, Americans owe an estimated $220 billion in medical debt, which can be seriously detrimental to their overall finances.
If you find yourself with a surprise medical bill, you have options. Here are some top resources to help you pay your medical bills.
No Surprises Help Desk
The No Surprises Act of 2022 limits how much you have to pay for out-of-network providers or facilities. It is defined to ensure you’re paying closer to what you’d pay if you’d received services in your network, according to the Consumer Financial Protection Bureau.
If you’re uninsured or self-pay for insurance, you should get a “good faith” estimate when you first schedule care with your provider. If the amount you’re billed is $400 higher than the estimate showed, you may be able to dispute it.
To do so, contact the No Surprises help desk or file a complaint online.
Government Program
The government has quite a few programs that can help you pay your medical bills. These include Medicare, Medicaid and the Children’s Health Insurance Program. Eligibility mostly depends on your income, but it never hurts to research your options.
If you’re dealing with a hefty medical bill that your insurance doesn’t cover, these options from USA.gov could help:
- Medicare Savings Programs that help with Medicare Parts A and B
- Medicare Extra Help for help with prescription drug costs
- Local or state charity care programs that can offset the cost of medical treatment
- State social service agency that can give you referrals to better or more affordable healthcare.
Payment Plan
Did you know you might be able to get on a payment plan rather than pay the entire bill at once?
“Most providers will allow you to spread the balance over time, often interest-free so don’t be afraid to ask about this,” said Linda Jensen, a chartered financial consultant, chartered life underwriter and certified financial fiduciary with Heart Financial Group. “Make sure you can afford the monthly amount, defaulting on a medical payment plan can hurt your credit if the debt is turned over to a collection agency.”
Itemized Billing and Negotiations
When you get an unexpected medical bill, one of the first things you should do is review it to make sure you’re getting billed only for treatment or services you actually received. After all, billing errors can happen.
You can request an itemized bill. Once you have that, cross-reference it with your insurance plan’s explanation of benefits to make sure everything looks in order. If it doesn’t, reach out to your provider and find out what’s going on.
Know that you might be able to lower how much you owe even if the amount is correct. According to Jensen, you may be able to get one of the following:
- Discount for prompt payment (best for those who have the cash on hand)
- Cash rate rather than the billed rate
- Balance reduction or forgiveness (best for those experiencing legitimate financial hardship).
“Always get any agreement in writing before making payments,” Jensen said.
Other Financial Assistance
By law, nonprofit hospitals must offer a financial assistance policy (FAP), per the IRS. Reach out to the hospital where you received treatment and request a financial assistance application. You may be required to submit documents verifying your income or financial hardship.
Eligibility for these programs depends on factors like income, financial hardship and household size. In some cases, the hospital will offer financial assistance even after you’ve received a bill — so long as you qualify.
Professional Assistance From a Nonprofit Group
Certain nonprofits, like the Patient Advocate Foundation, exist to help people with their healthcare and medical bills. If you receive a surprise bill, consider contacting one of these organizations to see if they can help.
The Patient Advocate Foundation, for example, has an independent division that provides grants to patients who meet medical and financial criteria.
More From GOBankingRates
Sources
- KFF, “What resources are available for privately insured patients who get surprise balance bills?“
- Consumer Financial Protection Bureau, “What is a “surprise medical bill” and what should I know about the No Surprises Act?“
- USA.gov, “How to get help with medical bills.”
- Linda Jensen, Heart Financial Group
- IRS, “Financial assistance policy and emergency medical care policy – Section 501(r)(4).”
- Patient Advocate Foundation, “Financial Aid Funds.”
