You go to the doctor because you want to be healthier, feel better or get well. But for millions of people in the United States, a visit can come with a bad side effect: huge bills that can lead to serious debt. One in five Americans struggles with medical bills. Here are seven things you can do to get medical bills reduced — or even forgiven.
1. Ask for help as soon as possible.
Paying medical bills is a struggle for a lot of people, which means there's actually a well-trodden path to figuring out what to do about them. You just have to know where to look and how to ask.
Jenifer Bosco, an attorney with the nonprofit National Consumer Law Center, says to call the hospital and ask if you qualify for the hospital's "financial assistance policy" — sometimes hospitals call it "charity care." If your income qualifies you for this help, sometimes the hospital might cut your bill in half or even forgive it completely. Nonprofit hospitals are required by law to have these assistance policies.
"If you're not eligible for true charity care or financial assistance — maybe your income is a little bit too high," says Bosco, "often people can negotiate the bills down anyway on their own behalf."
2. Don't pay the sticker price!
The hospital may bill you for the "chargemaster" rate, which is typically much higher than the price that insurance companies pay. It's sort of like the sticker price that hospitals use to negotiate with health insurers.
"They'll say, 'Well, our chargemaster rate is $10,000 for an MRI,' " explains Bosco. "But they might work out something with the insurance company to just charge $5,000 for the MRI. ... An uninsured person might be actually billed for the full chargemaster price."
You can call the hospital and health care provider, and you say, "I can't afford the sticker price. What's the lower price? What do you bill insurance companies or Medicaid and Medicare?" Find out that lower amount and ask for that.
You can also research fair prices for medical procedures through Healthcare Bluebook.
3. Be persistent.
Some hospitals are easier to deal with than others, but persistence can really pay off. It may take a long time — months or even years — to reach a deal you can afford. It's worth it to keep going.
"Channel your inner pushy lawyer," says Bosco.
4. Don't put medical debt on a credit card.
Paying by credit card shifts the debt away from the hospital — where your bills may have a low interest rate or even none at all — and into a high-cost form of debt.
"I would really advise people not to put their medical debt on a credit card if possible," says Bosco. "If you put it on a credit card, then you're losing whatever protections you might have for medical debt. Then it's just credit card debt."
Plus, putting the costs on a credit card means the hospital has been paid, which takes away its incentive to negotiate a lower bill or help you get on a payment plan.
5. Remember that medical debt is not as urgent as your other bills.
Pay your mortgage and credit card bills first, Bosco says — protect your home and your means to get to and from work, and don't run up expensive balances on credit cards.
Also, medical debt is not as damaging to your credit score as other debts — it's actually weighted differently. On top of that, federal law blocks credit bureaus from putting medical debt on your credit report until it has been past due for six months, leaving you time to negotiate with your hospital or insurance company. And after seven years, medical debt won't appear on your credit report anymore.
Not that you can just ignore your medical bills, but prioritize high-interest debt first.
6. Take steps to make debt collectors stop calling.
"You can get the debt collector to stop calling you," Bosco says. "Send them a no-contact letter. Tell them over the phone that you do not want to be called at the number that they're calling you at."
Instructions for do-not-contact letters can be found in the National Consumer Law Center's book Surviving Debt. (The digital version of the book is available for free during the coronavirus pandemic.)
Also, the states each have a statute of limitations for how long a debt collector has to sue you for debt. If you think that you might not actually owe the money and that the insurance company made a billing error, you can request an internal review from the company.
7. A nonprofit advocate can help.
If you're overwhelmed and drowning in a sea of medical bills, finding a good nonprofit advocate or counselor can be a really big help.
Bosco says to beware of scam outfits, though. "One thing to look for that could be problematic is if they're pushing loan products on you and they offer loans. That's probably not a place that's advocating for your best interest."
Working with a nonprofit organization is a smart approach. The National Foundation for Credit Counseling can help you find good credit counselors.
We'd love to hear from you. Leave us a voicemail at 202-216-9823, or email us at LifeKit@npr.org.
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This podcast portion of this story was produced by Sylvie Douglis.
This story was originally published on Feb. 18, 2019.