Sixty percent of the nearly one million personal bankruptcies filed
in the United States last year resulted from medical bills.
-- Steven Brill, America's Bitter Pill: Money, Politics, Backroom Deals,
and the Fight to Fix Our Broken Healthcare System (2014)
Most of us know how steep medical bills can be, but Mr. Brill points out just how damaging they often become, leading millions into bankruptcy over the years. Whether you've been a patient in a hospital, or are just struggling to pay healthcare costs despite your health insurance, there are programs that can help.
Here are some ways to get help with medical bills and keep them under control.
Minimize big medical bills
One great strategy is to try to avoid big healthcare bills in the first place. Getting as healthy as you can get, and staying that way, is one way to do so -- but it's not foolproof. Even fit and healthy people can get sick, or suffer injuries.
Being smart about your health insurance is another approach. For example, it can make good sense to get a plan with a high deductible, especially if you're healthy and expect low healthcare bills. Remember, though, that if a health crisis strikes, you'll be on the hook for some hefty cash outlays. Can you afford them? Give that some thought.
Be sure that you understand how your plan works, too. Many plans will cost you less when you see in-network doctors and/or are cared for at in-network facilities. It can pay to be sure that any care you're getting, including diagnostic tests and procedures, is entirely within your network. If a biopsy is sent to an out-of-network pathologist for evaluation, you may receive a surprising bill.
When it comes to prescription drugs, most insurers have lists of drugs that are preferred and for which they'll charge you less. Use that list, and share it with your doctor, so that he or she can keep it in mind when prescribing medicine. Whenever possible, generic alternatives are usually the best bet. It's also worth asking your doctor if he or she has any free samples of prescribed medicine. They often do, and that's free -- often saving patients a small bundle.
Many times, though, you'll do all you can to reduce your healthcare bills, but you can end up with steep bills anyway -- or with the prospect of steep bills around the corner -- for care you know you need. Fortunately, there are some programs and solutions that can help. (And remember, too, that many medical expenses may end up as tax deductions, especially if they're substantial.)
Check for errors!
The first thing to do if you're holding a steep healthcare bill is to examine it closely for errors. It's not uncommon at all for there to be mistakes that many people will not see, and will just pay for without realizing it. According to U.S. News and World Report: "A surprisingly large proportion of medical bills contain clerical errors that result in overcharges -- anywhere from 50% to 80% -- depending on who you ask. A recent NerdWallet analysis found that 49% of Medicare claims had errors, while medical billing advocates will tell you 80% of the claims they analyze have errors."
The folks at NerdWallet found common errors to include duplicate charges, canceled tests or procedures, incorrect quantities, and "upcoding" -- which is illegal, but happens anyway. This occurs when a provider, such as a hospital, enters a code for a higher-level (and more costly) service than the one you received.
Hospital and doctor bills are not set in stone. Many providers are willing to negotiate with you -- especially if it means getting paid something instead of getting paid nothing. It won't always work, but it's usually worth trying to get your bill reduced.
It can help to research what a typical cost is for a certain service, and then ask to be charged that. You may even be able to negotiate with your health-insurance company -- and at least get an extended payment plan. Some providers may be willing to accept less if you simply offer what you can pay today, as it will assure them of some payment, and save them the trouble of chasing payment later.
Don't expect them to accept $10 instead of $5,000, though. Get a copy in writing of any agreement reached. Providers or insurers may be able to connect you with helpers, such as social workers, who can help you, too.
Seek assistance in disputes
If you're not coming to any agreement in a dispute over healthcare costs, you might contact your state's insurance commissioner. They can often help -- or they might be able to steer you to some help.
The Affordable Care Act (Obamacare)
As I write this, Obamacare is under attack and may soon not exist in its current form, if at all. But for now, it does, and it can be a great help, offering a range of plans and subsidies for those who need help paying for premiums. Click over to www.healthcare.gov and learn about plans available to you, and when you can sign up. For most people, the Open Enrollment Period for a 2018 plan runs from November 1, 2017 to December 15, 2017.
Hospitals are not all alike. Some are for-profit and some are non-profit. You can probably guess which kind is most likely to offer free or reduced-cost care for those who need it.
It's best to look into what help is available before you check in to a hospital, so do some digging early, if you can. Even for-profit hospitals may have some kind of program to alleviate the financial burden of medical bills, or some kind of discounted-care program.
Yes, some medications cost an arm and a leg. Know, though, that some of the companies that make and sell these drugs also have programs to help financially strapped people -- typically ones without prescription-drug coverage -- get medicine for free, or at a reduced rate.
You might have to check with each company, and you may end up needing your physician to fill out and send in some forms for you. Two sites that can be of particular help: RXAssist.org and Partnership for Prescription Assistance. Also, check out The Assistance Fund and the Patient Access Network Foundation (PAN).
If your steep medical bills are due to your dealing with a particular disease, there may be organizations or programs that can help you. A little Googling online can turn up some possibilities. Below are some examples of organizations or programs that help people deal with certain diseases, as well as some that offer broader aid, generally for people of limited financial means:
Diseases or Conditions
Leukemia and lymphoma
Huntington's disease and some "orphan diseases"
Crohn's disease, rheumatoid arthritis, multiple sclerosis, and more
Osteoporosis, ovarian cancer, hepatitis, etc.
If you're elderly, disabled, or not well, you may qualify for free or discounted dental care from the Donated Dental Services (DDS) program, which is a network of more than 15,000 dentists nationwide.
If you are, or your child is, aged 18 or younger, and either one of you is uninsured and in a low-income household, you may be able to get free vision examinations and glasses from Sight for Students. EyeCare America, Vision USA, and New Eyes for the Needy offer eye care from volunteer eye specialists and/or glasses to qualifying people. If you can't afford cataract surgery, Mission Cataract USA may offer it to you.
You can look into available help with hearing problems via the Hearing Loss Association of America, and if you are or care for someone aged 19 or younger with a hearing or listening aid, you may qualify for financial help from The HIKE Fund.
Find available assistance
There are many more programs to help those struggling with medical bills -- and facing other problems, too. You can (anonymously!) look up government benefits (both federal and state) that you might qualify for by visiting Benefits.gov. Social workers specializing in healthcare issues may be able to help, too.
Hire an advocate
There are people you can hire -- medical billing advocates and private patient advocates -- who can do a lot of the work negotiating with healthcare providers to resolve steep bills. Some can help oversee your care, too, as they know lots of ways to improve your care, such as finding clinical trials you might qualify for, or monitoring your bedside care, or even helping you with decisions you're asked to make.
They don't generally work for free, though, and they may charge you a percentage of what they save you, or hundreds or thousands of dollars. Even so, that can be well worth it, as they can improve your care, take a lot of work and worry off your plate, and save you more than they cost you.
This may seem like an extreme step, and it may feel uncomfortable, but if you're really stuck, you might appeal to the generosity of strangers through a crowdfunding site such as GoFundMe and YouCaring. Try to spread word of your campaign online, in order to reach as many possible helpers as possible.
Fund an emergency fund
Finally, a great way to be able to pay surprisingly large medical bills is to be prepared for the possibility of them -- by having a fully stocked emergency fund. It's generally advised that such a fund hold at least three to nine months' worth of all your living expenses, including housing, food, transportation, utilities, etc. It can save you if you experience a sudden job loss -- or also a medical emergency.
Clearly, there is a lot of assistance available if you need help paying your medical bills. Finding the help you need is easier said than done, though, so the list of resources and suggestions above should help.