NEW YORK — Unexpectedly high medical bills are common in the United States, but there are ways to get relief. According to the Consumer Financial Protection Bureau, one in five Americans are affected by outstanding medical debt, for a total cost of $88 billion.
While the process of fighting high medical bills can be time-consuming and frustrating, advocates stress that patients shouldn’t be intimidated by the system. If you’ve received a surprise medical bill, here’s what you should know:
- Always see if you qualify for charity care
When Luisa, 33, received a medical bill for over $1,000 after an emergency hospital visit for a viral infection, she was able to have the whole amount covered by the hospital after appealing to their financial assistance policy.
“At first I thought it was just a cold, but it turned out to be something I needed specific medication for,” said Luisa, who asked to be identified only by her first name due to privacy concerns. “It was really bad by the time I went to the ER.”
Luisa had heard about the patient advocacy organization Dollar For thanks to a viral video, and she filled out the nonprofit’s online form after receiving her surprise bill. The organization contacted the hospital. Eventually, the hospital contacted Luisa directly to let her know she did in fact qualify for financial assistance.
Laws governing hospital charity care require that nonprofit hospitals lower or write off bills for individuals, depending on household income. To determine if you qualify, you can simply Google the hospital along with the phrase “charity care” or “financial assistance policy.”
- Appeal to the No Surprises Act
While protections against surprise bills have long existed for those who have Medicare, Medicaid and Tricare, laws are now also in place for those with private or marketplace insurance.
The federal No Surprises Act covers people who have insurance through their employers, the marketplace or individual plans. It says that insurance companies must reasonably cover any out-of-network services related to emergency and some nonemergency medical care. That means that if you’re being charged more than you’re used to or expect when you receive in-network services, that bill may be illegal.
To challenge any bill covered under this law, you can use the free help desk and hotline of the Centers for Medicare and Medicaid Services.
Even if you don’t qualify for charity care or you’re not sure your bills are covered by the No Surprises Act, you may be able to reduce the charges.
Medical billing is notoriously byzantine and rife with errors. Anytime you receive a bill, ask the hospital or health care provider for an itemized bill that includes the billing codes of all the care you received.
