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In a 2022 study, the bureau found that roughly 20% of U.S. households report that they have medical debt, with collections appearing on 43 million credit reports. As of the second quarter of 2021, 58% of all bills in collections on credit records were medical bills.<\/p>\n
Medical debt affects households unevenly, too, according to the agency. Past-due bills are more prevalent among Black and Hispanic people than white and Asian people, and medical debt is more common in the Southern U.S., in part because states in that region did not expand Medicaid coverage.<\/p>\n
While the process of fighting high medical bills can be time-consuming and frustrating, advocates stress that patients shouldn\u2019t be intimidated by the system. If you\u2019ve received a surprise medical bill, here\u2019s\u00a0what you should know<\/a>:<\/p>\n 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.<\/p>\n \u201cAt first I thought it was just a cold, but it turned out to be something I needed specific medication for,\u201d said Luisa, who asked to be identified only by her first name due to privacy concerns. \u201cIt was really bad by the time I went to the ER.\u201d<\/p>\n Luisa had heard about the patient advocacy organization Dollar For thanks to a viral video, and she filled out the nonprofit\u2019s online form after receiving her surprise bill. The organization contacted the hospital, which was based in central Florida. Eventually, the hospital contacted Luisa directly to let her know she did in fact qualify for financial assistance. Even though she had already paid a portion of the costs with a credit card, Dollar For was able to get those payments refunded.<\/p>\n 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<\/a> the hospital along with the phrase \u201ccharity care\u201d or \u201cfinancial assistance policy.\u201d Dollar For also provides\u00a0a simplified online tool<\/a>\u00a0for patients to see if they qualify.<\/p>\n \u201cFederal law requires hospitals to have these programs to keep their tax-exempt status,\u201d said Jared Walker, CEO of Dollar For. \u201cIf you\u2019re within their income range, they will write off, waive, forgive, or reduce your bills.\u201d<\/p>\n Even if you\u2019ve already been paying off medical debt, the hospital will be required to refund the payments you\u2019ve made, he said.<\/p>\n \u201cIt was my first time going through something like that,\u201d Luisa said. \u201cI tried to be an informed consumer and ask questions when I was in the hospital about the costs, but obviously it\u2019s hard when you\u2019re sick in the emergency room.\u201d<\/p>\n 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.<\/p>\n 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 non-emergency medical care. That means that if you\u2019re being charged more than you\u2019re used to or expect when you receive in-network services, that bill may be illegal.<\/p>\n To challenge any bill covered under this law, you can use the free help desk and hotline of the\u00a0Centers for Medicare and Medicaid Services<\/a>. Many states also have\u00a0free consumer assistance programs<\/a>\u00a0to help with disputes and insurance questions. You can always contact the medical billing department of any hospital in writing to say that you believe a bill is in violation of the No Surprises Act and ask the hospital to deal directly with your insurance company.<\/p>\n \u201cThe complexity of the system itself is as big a problem as affordability,\u201d said Kaye Pastaina, who heads research on patient protections for KFF, a nonprofit health policy organization. \u201cA lot of it is from the fragmented system and complex rules, but also lack of awareness about existing protections that are a part of federal law that might help.\u201d<\/p>\n Even if you don\u2019t qualify for charity care or you\u2019re not sure your bills are covered by the No Surprises Act, you may be able to reduce the charges.<\/p>\n Medical billing is notoriously byzantine and rife with errors. Anytime you receive a bill, ask the hospital or healthcare provider for an itemized bill that includes the billing codes of all the care you received. The Health Insurance Portability and Accountability Act (HIPAA) mandates that providers share this information.<\/p>\n Next, check whether the billing codes are accurate. Again, simply Googling the codes with the phrase \u201cmedical billing code\u201d can help. If something is off, contesting your bill with your medical provider or physician\u2019s office can yield changes.<\/p>\n Another approach: comparing the bill with insurance companies\u2019 estimates of fair charges for services. If the price you were charged is more than average, you can have your costs lowered. You could even take the provider to small claims court over the discrepancy (or let them know you have a case).<\/p>\n Finally, compare your insurance company\u2019s \u201cexplanation of benefits\u201d to the bill. This explanation of costs covered and not covered must match the hospital\u2019s bill. If they don\u2019t, you have another reason not to pay, and to ask the provider to work with your insurance company further first.<\/p>\n Despite the hassle, these steps can save you considerable sums of money. Even after taking these steps, you can always appeal health claims with your insurance company, if you think there is any reason the bills should be covered entirely or more than the company initially decided. You can also contact your state insurance commissioner for support.<\/p>\n \u201cWhat we\u2019ve seen in our research and the data is that those folks who appeal \u2014 and there are few who appeal \u2014 but for those who appeal, there\u2019s a high level of overturning,\u201d Pastaina said.<\/p>\n<\/div>\nAlways see if you qualify for charity care<\/h2>\n
Appeal to the No Surprises Act<\/h2>\n
Ask for an itemized bill<\/h2>\n
Remember the process requires persistence<\/h2>\n
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