This chapter provides tips and resources to tackle high medical bills

Ten tips for paying a high medical bill

If you have received a high medical bill, try not to panic. It’s essential to take action before your account is past due or goes to collections. Communication with the medical provider or facility is critical. The goal is to reduce your bill to affordable payments or eliminate the balance.

Here are some steps you can take to tackle a sizeable medical bill.

1. Make sure the debt is legally due

Under the No Surprises Act, which became effective in 2022, private insurers can no longer bill you extra for most emergency services — even if the services were out of network or did not have prior authorization. And you can’t be charged extra for out-of-network services received at an in-network facility. The new law also bans balance billing, when providers hold patients responsible for the remainder of a surprise bill after their insurance company pays the in-network charges.

2. Verify the charges are accurate

One crucial step is to verify the accuracy of the charges on your bill. Check the dates and services to ensure you’re not being overcharged. Thanks to hospital price transparency, you can compare the price of a service, item, or procedure at different facilities to ensure fair billing. If you have health insurance, make sure your plan has paid its share.

3. Request a discount

Don’t hesitate to ask for a discount from the billing provider. They may be willing to reduce the amount owed, especially if you don’t have insurance or choose to pay out of pocket. Asking to be charged at Medicare rates can lead to substantial discounts.

4. Seek debt forgiveness or debt settlement

Debt forgiveness or debt settlement are other ways to reduce your medical bills. They differ from receiving a discount, which reduces the official amount owed. 

Debt forgiveness, or debt cancellation, occurs when a creditor no longer pursues a debt. Providers may report the wiped debt to the IRS, and the amount could be taxed as income. Debt settlement or paying less than what providers charged you can impact your credit score; providers may report the unpaid amount to the IRS.

5. Ask about financial assistance programs

It’s important to explore financial assistance programs that can help with healthcare and medical expenses. You may qualify for help paying bills and even medical debt forgiveness. The U.S. Department of Health and Human Services maintains a state-by-state list of over 100 such programs. 

Many hospitals require you to apply for Medicaid to see if you qualify for government insurance for low-income people. Then, if you’re not eligible for Medicaid coverage, you can apply for help with medical bills from the hospital. That application may include providing copies of pay stubs, bank statements, tax returns, and other financial documents.

6. Ask about indigent care and charity care programs

Under U.S. law, nonprofit hospitals must provide charity care. Some for-profit hospitals do, too. These programs offer free and low-cost medical treatment — including emergency room services — for people who can’t pay. Providing charity care allows hospitals to write off some or all of their charges.

7. Set up a monthly payment plan

If none of the earlier advice knocks down your bill, offer to make monthly payments directly to the healthcare provider. This is a better option than potentially high-interest medical financing, paying the bill with a credit card, or not paying at all. 

Although they may include a late fee, medical bills rarely charge interest. In many instances, paying something monthly—even a fraction of the balance—can prevent the bill from being turned over to a collection agency or damaging your credit.

8. Find special help if you’re a veteran

If you are a veteran, Veterans Affairs (VA) offers free debt counseling and may be able to help you find assistance for medical bills. In April 2022, the White House announced that the VA would stop reporting most unpaid VA Care medical bills to credit agencies and would provide more assistance to help veterans eliminate their medical debt.

9. Consider debt consolidation

Debt consolidation can help you avoid bills going into collections and unpaid medical debt hurting your credit score. You can also prevent lawsuits and bankruptcy. 

Medical debt consolidation could mean securing a personal loan, 401(k) loan, home equity line of credit, or credit card to pay off medical debt. You’ll preserve your creditworthiness and have more time to pay. But, this new debt might temporarily damage your credit score and likely mean you will add these monthly payments to your budget.

10. Use bankruptcy if you have no other options

As a last resort, bankruptcy may be the right option to address your medical debt. Chapter 7 can help you liquidate assets to wipe out your debt. Chapter 13 is a reorganization where you pay all or some of your debts in 3 to 5 years. Your credit score typically drops when you file bankruptcy.

How can charitable organizations help with a medical bill I can’t afford?

There is hope in the form of many nonprofit organizations that assist with medical bills. For instance, Cameron’s Crusaders provides a ray of hope by helping with medical bills for children in the New England area. The HealthWell Foundation eases the burden for underinsured individuals by helping them pay out-of-pocket costs not covered by their health plans. Organizations such as RIP Medical Debt are working tirelessly to abolish medical debt, offering a glimmer of hope for a debt-free future.

Some other nonprofits that can help with medical bills — many for specific conditions and circumstances — include:

• CancerCare, which offers copayment assistance for people with insurance 
• Leukemia & Lymphoma Society, which provides financial assistance to people with certain conditions
• Patient Access Network (PAN) Foundation, which helps underinsured people with life-threatening, chronic, and rare conditions
• Patient Advocate Foundation is a good starting point to find grant programs for which you are eligible that can help you cover medical expenses
• UnitedHealthcare Children’s Foundation, which offers grants of up to $5,000 for specific medical costs
• Upsolve a free online community that helps people with debt, including legal help

The bottom line

When you receive a medical bill you can’t pay, it’s not a time to feel helpless. It’s essential to take action. Don’t wait for the debt to become overdue. You want to avoid debt collectors, a negative impact on your credit score, and additional stress. Always remember that you have options and taking action empowers you to explore those options. 

First, ensure that the provider’s bill is accurate and that you are responsible for it. Then, stay in communication with the healthcare creditor. You can ask for a discount or payment plan or see if the hospital will forgive or settle your debt. 

Organizations could also help. Check on whether you qualify for a charity care or financial assistance program, or ask for help from charitable organizations that can assist you. The process usually involves filling out an application form and providing some financial information, such as your income, expenses, and any existing debts. If you’re a veteran, reach out to the VA. 

Consider debt consolidation if something else is needed and you have multiple medical bills you can’t pay. Bankruptcy is a last resort.

GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and from peer-reviewed scientific journals. You can be confident in the accuracy, thoroughness, and unbiased nature of our content. Good Rx advises to read their editorial guidelines to learn more about content that is accurate, thorough, and unbiased.

The resources mentioned below were used for the above material and I am sincerely grateful for the helpful information to the patients:

Good Rx 12/20/2022 update by Cindy George, MPH

Elizabeth Rosenthal Book : An American Sickness and various articles written by her in the New York Times. She is the current Senior Contributing Editor, Health News Analysis, Kaiser Family Foundation News (KFF News)