According to the Kaiser Family Foundation’s latest report on medical costs, 29 percent of adults in the U.S. struggle to pay their medical bills. Among this group, almost three-quarters report cutting back on simple household items — even food — to stay on top of these bills. More than a third increased their credit card debt as a result.
And those bills can have a direct effect on your health. A recent survey by healthcare transparency company Amino found 1 in 5 respondents avoid going to the doctor because of the potential cost.
Don’t let a fear of medical debt get in the way of your life. Here’s a guide to paying medical bills you can’t afford through the art of negotiation.
How to pay medical bills you can’t afford in five steps
But you have more leverage to bargain than you might think. Here are a few tips to help you get started.
1. Review your medical bills
Before you get started with the negotiation process, review your medical bills. Carefully go over them the same way you’d review your credit card bill or bank statement. Keep an eye out for an explanation of benefits from your insurance company. Additionally, ask your medical provider for an itemized bill so you can see all the charges.
Review doctor or hospital visits you made, tests you took, and treatments you received to make sure everything lines up. It’s not unheard of for medical bills to contain errors.
In fact, the most recent data published by the American Medical Association shows 7.1 percent of medical bills paid contained errors.
How expensive can these errors be? Huffington Post recently reported “hospital bills totaling more than $10,000 contained an average error of $1,300,” according to an audit by credit rating agency Equifax.
If you’re not sure what you’re looking at when you review your bill, call your medical provider’s office and ask for clarification. You can also call your insurance company to question any expenses that weren’t covered. There’s a chance that they denied you coverage because of a technicality that could be overruled. The even may have denied coverage because of a loss of important information.
Let’s say you needed a referral to see a specialist to have that visit covered by insurance. If for some reason the insurance company didn’t know about the referral, they could charge you unfairly. That would be a charge to dispute with your insurance company, not your doctor.
Another thing to look for is surprise billing. For example, if you saw a doctor at an in-network facility, only to later find out the doctor was out-of-network. So you might have thought you were in the clear only to realize that there’s an extra charge not covered by your insurance company. Fighting this could be difficult, but you should at least know about it for next time.
Once you’re sure that all of the information on your medical bills is correct, you can move on to the next step of the process.
2. Talk to your medical provider about financial aid
The next step is to ask your medical provider if they offer assistance. For example, if the cause of your medical debt was a trip to the hospital, you might get part of your bill lopped off if your income falls within a certain range.
A colleague of mine, Claire Murdough, learned about this option during a scary financial time. When we met, she was working for my company as an intern and getting paid by the hour. Since she was not able to qualify for employer-sponsored insurance, and she had student loans to pay off, she took a risk. She opted not to buy a health insurance plan for herself. In her words:
“I had a choice to either pay the $300+ monthly premium or cross my fingers and hope my youth would be enough to keep me healthy. As you can probably guess, crossing my fingers didn’t work out for me. About six months into my ‘plan,’ I got a kidney infection which required me to go to the emergency room for treatment. It was terrifying.”
Murdough decided she had to negotiate the $7,000 bill she received for an IV, antibiotics, and tests. She contacted the hospital and found out she could talk to a financial advisor about her bill. Luckily, she went to the meeting prepared.
“The advisor looked at my bank statements and the paycheck stubs I brought in and said my income was within the bracket for a discounted bill. She asked that I verify a few things (by email and fax) and then was able to reduce the total cost by about 40 percent.”
Though the cost was still large, this reduction helped Murdough find some financial relief. So, what about you?
If you receive a huge medical bill, call your hospital. Ask to speak to the department that manages financial assistance. You can also Google those phrases with your hospital’s name to find the phone number directly.
Make sure to gather whatever paperwork the department says they’ll need from you. The more prepared you are, the easier this will be for you and the advisor trying to help you.
3. Compare the costs on your bill to those of other medical providers
If your income is too high to qualify you for financial assistance, there are other tools you can leverage to negotiate. One of these is to compare the costs of your medical care with those charged by other providers.
Websites such as Amino and Healthcare Bluebook enable you to research the cost of different medical procedures where you live. Not only can you use this in negotiations if your provider charged you more than others might have, but it can be a helpful step to take before future medical procedures. (Who knew you could price-shop for medical care?)
Although some doctor’s offices and hospitals might justify why their procedures cost more than at other facilities, this knowledge still gives you leverage to negotiate your bill down. The first person you speak to might tell you there’s nothing they can do, but be persistent. Continue to ask to speak with a higher-up until you have a substantial conversation about the amount they’re charging you.
According to Consumer Reports, once you’re talking to someone with authority, you can improve your chances by framing the conversation around what you can pay, your desire for a fair price, and your knowledge of the price insurance companies pay — especially if part of your care was done by out-of-network providers that you had no choice but to use.
4. Ask if you can get a prompt pay discount
If you have enough cash on hand to pay your medical bills, you can still try to negotiate them down by using something called a “prompt pay discount.” This is a discount some medical providers will give to collect on the bill quickly.
Given the fact that medical debt is the most common reason a debt collector might contact a consumer, it might not come as a surprise that medical providers want to incentivize fast payment.
U.S. News interviewed the founder of Medical Billing Advocates of America and Medical Recovery Services, Pat Palmer. She explained the prompt pay discount could get you 10 to 20 percent off your bill. But you should still check for errors on the bill first so your discount will be applied after you’ve negotiated the full price of the bill.
5. Request a payment plan
Finally, negotiate when and how you should repay your bill. Depending on the amount of the bill, paying it all at once could leave you financially strapped.
Ask your provider if they’ll set up an interest-free payment plan for you. Some might try to get you to sign up for a healthcare-specific credit card, but that’s not the same thing. What you want is an agreement with them in which you can pay a smaller amount in a set number of installments to eventually equal the total amount you owe.
Some hospitals might not just offer a payment plan, but a legitimate no-interest loan. NBC recently reported on this trend and shared the story of a man who was able to pay off a $2,800 bill in three years at only $80 per month. While he didn’t pay less than he owed, this loan made the amount due much more manageable.
And if they are willing to do this, get the agreement in writing. Otherwise, you could follow the plan you both set out on only to realize that your medical debt was sent over to a collections company.
Speaking of medical bills in collections…
What to do about medical bills in collections
Figuring out how to pay medical bills you can’t afford is one thing, but figuring out how to pay medical bills that have already gone to a collection agency is another story.
If you have medical bills in collections, it’s still a good idea to make sure you review your bills for errors and dispute them if they come up. But as for paying off the medical debt, here are a few tips to help.
- Ask the debt collector for a payment plan. Since you might not be able to pay the debt in full right away, write out a budget to figure out how much you can afford to pay each month and then propose that plan to the debt collector; just be sure to get their agreement in writing.
- See if you can settle for less than you owe. If you’ve saved a chunk of money that you can afford to pay upfront, offer that to them as a settlement to see if they’ll forgive the rest of the debt in an effort to get it paid off faster — remember, they didn’t pay full price for your debt so they might be willing to negotiate.
- Consider the statute of limitations on debt. If several years have passed without you making payments on the debt, it might become “time-barred.” This means you still owe it, but you can use the statute of limitations on debt to defend yourself if you get sued for collections. Although debt collectors aren’t required to stop contacting you about the debt, they can’t successfully sue you for the money if the statute of limitations is up.
Take control of your health — and your medical bills
Medical bills can be terrifying, especially since it’s so hard to know in advance what the cost could amount to. But there’s no reason to fear. Remember that when it comes to medical debt, you do have options.
Follow the steps outlined above to empower yourself to negotiate a lower price or, at the very least, a fair payment plan.
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