If you can’t pay a medical bill, review the charges and check whether your insurance was applied correctly. Then ask about financial assistance, a payment plan, or other options; contact the provider’s billing office quickly to discuss questions about the bill.
What to have in front of you
- Your medical bill or billing statement.
- An itemized list of charges, if you have one.
- Your health insurance policy documents and explanation of benefits.
- Information about any payment you may already have made.
- If you’re in the Qualified Medicare Beneficiary program, your Medicare and Medicaid or QMB card and your Medicare Summary Notice.
Check the bill
The Consumer Financial Protection Bureau, or CFPB, recommends checking the bill before paying it. Look at whether the provider calculated it accurately and whether your health insurance was applied correctly.
Check whether you have already paid the bill. It is also possible for a provider or debt collector to confuse you with someone who has a similar name.
Review the charges for errors. For example, look for a charge for the same service or treatment twice. If something does not look right, you can ask for an itemized list of charges.
If you are unsure about a charge, talk to the provider’s accounting or billing office. Use the contact information on your billing statement. The CFPB recommends doing this quickly so you can work on resolving charges and avoiding late fees and interest.
Consider whether it is a surprise bill
A surprise medical bill can arise after care at an out-of-network facility or from an out-of-network provider when insurance does not cover the out-of-network cost.
The No Surprises Act provides protections in some situations. For people with insurance, it bans certain practices, including requiring payment of out-of-network charges for emergency services. It also provides some protections for people who are uninsured.
In some situations, the law can protect you from owing the difference between the out-of-network billed cost and the amount your insurance paid. Check whether it applies to your bill. Some services, including ground ambulance transportation, are not protected by the No Surprises Act.
Ask about financial assistance
Financial assistance programs, sometimes called charity care, provide free or discounted health care to people who need help paying medical bills.
The Affordable Care Act requires hospitals with 501(c)(3) nonprofit status to have programs that provide this care. Some states also have charity care laws requiring hospitals to provide additional free or discounted care.
Ask about financial assistance when you contact the provider. You can also look for help with medical bills, prescription drugs, and other expenses. Some nonprofit organizations offer financial help or help with drugs needed for medical care or certain medical conditions.
Ask about other payment options
If a balance remains after you review the bill and look into assistance, the CFPB lists these options:
- Negotiate the bill down to an amount you can afford.
- Ask whether the provider will accept an interest-free repayment plan.
- Look for other help paying medical expenses.
The CFPB advises being careful about using a credit card or medical credit card to pay the bill. Interest may be high, and you may lose the ability to negotiate the debt. An interest-free repayment plan may be another option to ask about.
If you disagree with a charge
If you disagree with charges or want more information, you have the right to appeal with your health insurance company. The CFPB says you have a right to both an “internal appeal” and an “external review.” Check your insurance policy documents and explanation of benefits.
You can also dispute a medical bill with a debt collector or a credit reporting company. The CFPB describes protections related to faulty credit reporting and contact from debt collectors.
If a billing dispute remains unresolved, state Consumer Assistance Programs may help with health insurance problems. A state attorney general, insurance department, or insurance commissioner may also offer information and a complaint process.
For a debt collection or credit reporting problem involving a surprise medical bill, you can submit a complaint to the CFPB online or by phone.
Medicare and veterans’ options
If you are covered by the Qualified Medicare Beneficiary program, providers should not bill you for Medicare-covered services and items, including deductibles, coinsurance, and copayments. If a provider will not stop billing you, the CFPB says you can call Medicare. Medicare can ask the provider to stop billing and refund payments you have already made.
Veterans may qualify for financial hardship assistance, including repayment plans, copayment exemption, and debt relief. For a billing dispute, you can write a letter explaining the situation and submit it to your local VA medical center with “Billing Dispute” on the envelope.
Where this comes from
Consumer Financial Protection Bureau: What should I do if I can’t pay a medical bill?