What if you can't pay your medical bills?

Buried in medical debt? Here are steps you can take to lower the bill, sometimes quite substantially.

By MSN Money Partner Sep 2, 2014 1:39PM

This post comes from Allison Martin at partner site Money Talks News.


Money Talks News on MSN MoneyIf you or a loved one has ever experienced a serious illness, you know how quickly the medical bills can pile up.

Medical doctor © Sean Justice/CorbisOne day, it's a bill for services rendered by the anesthesiologist. The next day, the radiologist wants his cut. Wasn't this all supposed to be included in the hospital bill?

Fortunately, limits on out-of-pocket expenses included in the Affordable Care Act for 2014 apply to many insurance policies, whether you get your insurance through your employer or purchase it on your own.

That means an individual can pay no more than $6,350 out of pocket for in-network care. The limit is $12,700 for families. That limit includes co-payments and deductibles, but doesn't include the cost of monthly premiums.

But there are still ways to rack up big medical bills:
  • If your health insurance plan at work has a separate administrator for medications, your spending on prescription drugs might have a separate limit or perhaps none at all until that rule changes in 2015. So you could conceivably be facing large bills from the pharmacy.
  • Health care plans that were grandfathered in are exempt from the limits. "Grandfathered plans are those that were in existence on March 23, 2010, and haven't been changed in ways that substantially cut benefits or increase costs for consumers," says HealthCare.gov. "Insurers must notify consumers with these policies that they have a grandfathered plan."
  • You might have other expenses that aren't included in that out-of-pocket maximum. "This limit does not have to count premiums, balance billing amounts for non-network providers and other out-of-network cost-sharing, or spending for nonessential health benefits," says HealthCare.gov.
  • Your health insurance plan may limit your out-of-pocket spending for non-network care or it may not.
  • Your health insurance plan may limit your out-of-pocket spending for non-network care or it may not.
  • And here's a biggie: You ignored the federal mandate to buy health insurance.

So, if you have big medical bills, what should you do?

1. Don't ignore medical bills

Medical debt that you don't pay can have a huge impact on your credit score. In fact, Experian says more than 64 million Americans have a medical bill in collections on their credit report.

According to The Wall Street Journal:

More than half of all debt collection activity on consumers’ credit reports comes from medical bills, according to the Federal Reserve. Such activity results in lower credit scores for consumers, meaning that lenders are more likely to be cautious in extending credit.

The Consumer Financial Protection Bureau recently called on credit-scoring companies to treat medical debt differently from other unpaid bills, saying that medical debt is often unexpected, unlike other bills that go into collections.

Since then, FICO, a major credit-scoring company, has issued a new scoring formula that reduces the impact of past-due medical bills on credit scores. But it could be some time before that score is widely adopted by lenders.

2. Examine your bill and explanation of benefits

According to Medical Billing Advocates of America, 8 in 10 hospital bills probably contain errors. Donna Fuscaldo of FoxBusiness suggests you request itemized bills from your medical care providers and then examine them carefully to determine that you truly received the services.

Next, compare them with the explanation of benefits statement from your insurance provider, which explains what it paid for and what you owe.

If you notice inaccuracies or discrepancies, call the medical care provider to question the bill.

As we said in "10 ways to fight high medical bills":

Common errors include charges for medications never administered and services never rendered. Sometimes patients are double billed or charged for room items that should have been included as part of a stay.

3. Negotiate

If you can't afford to pay the bill, explain your situation to the medical care provider. Perhaps they'll be willing to accept a smaller amount of money or will entirely wipe out the bill. Many hospitals have charity care programs that cover the bills of low-income patients.

Keep in mind that if you don't have insurance, your original bill will likely be much higher than the negotiated rates medical providers get from insurance companies, so there's some wiggle room in that bill.

Perhaps you could benefit from the help of a paid advocate, who will charge either a percentage of the money saved or an hourly rate.

4. Set up a payment plan

Another alternative is to call the billing department and set up a monthly payment plan. Whether interest will be charged depends on the medical provider's policy. As long as you keep paying, the debt likely won't affect your credit score.

5. Find help with medical debt

You can visit Benefits.gov to learn more about federal programs you may qualify for. This government website also provides information about help with medical bills.

Some nonprofit organizations also provide help to those who can't afford medical bills. Drug companies have programs to help people with the cost of prescription medications.

Karen Datko contributed to this article.

More from Money Talks News


Sep 2, 2014 3:59PM
I don't expect to get medical services that I can't pay for.  I don't believe that everyone is automatically entitled to them.   However, I do believe that everyone should be able to, for instance, get a broken arm set, and that shouldn't cost thousands of dollars. 
Sep 2, 2014 5:15PM
Don't pay!  That's what most people do anyway!  Besides, if die, you not going to know how long you were here anyway.  So what does it matter?  Why pay exorbitant amounts to stay alive, enriching those in the health profession, when in the end it doesn't matter anyway?  Heath care in America is out of control.  Chances are, the prescriptions you take aren't guaranteed to change the outcome and I'm sure without asking that there is no money back guarantee if they don't work.
Sep 2, 2014 3:36PM

Another article for the dependency class and how to get out of meeting their legal obligations.

Wonder when we will see one on "What if you can't afford your child care payment?" 

Sep 2, 2014 4:35PM
in the address bar for billing put down 
is 1600 Pennsylvania Ave NW, Washington, DC 20500
Sep 2, 2014 6:09PM
I think that Obumma gets free medical care since he obviously has no brain to get worked on.
Sep 2, 2014 6:01PM
I read these responses that make a joke or refer to ethnicity or blame someone or something for the bills. Guess what folks, medical care is not cheap for anyone. My 4 married kids have workplace coverage and they pay through payroll deductions an average of $7500.00 per year, plus co pays and deductibles for medical, dental and vision. My wife and I are on Medicare (individual not group) My cost for B, C and D in 2013 was $5,220.00 and my wife a little healthier was $4,680.00. Medicare does not cover vision or dental, that is out of pocket and together in 2013 my wife and I paid $2,540.00. Obamacare, private insurance, group insurance, no insurance, little insurance, Medicare, Medicaid or charity. Now, think about 19% of our annual countries income paying for medical treatment and climbing every year. If we can make a joke of that, so be it.
Sep 2, 2014 4:36PM
Don't worry, we have Obamacare.  All is well.
Sep 2, 2014 6:38PM

Questions: What if you can't pay for your healthcare? What if you can't pay for your food? What if you can't pay your mortgage? What if you can't pay for your childrens school lunch? What if you can't pay for daycare for your children? What if you can't pay for your cellphone?

Answer: Vote for the Democraps because they pander to leeches, parasites, freeloaders & moochers. They will provide you with "SUBSIDIZED" Obozocare, foodstamps, section 8 housing vouchers, provide your children with free school breakfasts, lunches (dinner can't be far behind), universal daycare and an Obamaphone. Paid for of course by the productive hardworking taxpayers... 

Sep 2, 2014 8:17PM
My late husband had cancer or 5 years. we had insurance. Paid about $20,000 off and when he died, I was left with over $20,000 that I couldn't pay in my lifetime. I was very grateful that the hospital forgave my debt. This was something that blindsided us on top of my husband's job going to Mexico and him being unemployed for 2 years. 55 years old  and no job. It's easy to call someone a deadbeat but life sometimes dumps crap your way and and its hard to climb out of that hole. I get that a lot of people don't even try, I know a few that would rather get the handouts myself. but there are just as many people that would rather be responsible for our debts. It can happen to all of you too. I know a few smug people that think that we failed to plan. I sometimes wish they would go through what we had to go through to get an understanding that life doesn't go according to the plan.
Sep 3, 2014 9:36AM
ALWAYS ask up front what the charge will be or an estimate of the charges. Don't assume anything as you may be charged by your doctor for a procedure, then charged for the outpatient hospital room the procedure was performed in, then charged for the anesthesiologist, then charged separately for reading MRI's X-Rays etc.  They LIE BY OMISSION so you must ask the right questions. What you might believe is a $500.00 charge for a procedure may turn into a $4000.00+ charge.  Your insurance might only cover a portion of the charges or NONE of them as in the case of cosmetic surgery, know what to expect beforehand.
Sep 2, 2014 5:30PM
"can't pay your medical bills, HUH" ............... THEN YOU DON'T GOT OBUBUCARE THEN DO YA!
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