Q. I have insurance, but I still have bills that are stressing me out. I thought I'd be covered, but I don't know how I'm going to pay the part I'm being told I owe.
If you are insured and struggling with outstanding medical bills, consider the following options:
- Read your insurance policy and understand the terms of your contract. If you have questions, ask your insurance company, insurance broker, or the human resources staff at your employer to explain it to you. Your insurer may have denied a claim even though you are entitled to coverage. HealthCare.gov has an excellent guide on how to dispute claims with your insurer.
- Double check all bills and EOBs (explanation of benefits). You’d be surprised how often billing mistakes are made. Look for incorrect dates of service (you shouldn’t be billed for the room on the day you were discharged) and duplicate fees for tests and procedures.
- Ask the hospital or doctor to consider the insurance payment as “payment in full.” Many people don’t think to do this, and it is often more successful than expected. Some hospitals have funds to offset medical services that aren’t fully covered by insurance.
- Negotiate the outstanding balance by asking for a discount. According to a Wall Street Journal survey, 70% of adults who talked with a hospital say they were successful in negotiating a lower price for their medical bills; 61% were successful with their doctor. You will likely get a greater discount (sometimes as high as 50%) if you pay the outstanding balance in a lump sum. You can also set up a payment plan.
- The Volunteer Lawyers Project of the Boston Bar Association offers good advice on medical debt. Although some of the information is specific to Massachusetts, sections like “deciphering a medical bill” and “negotiating tips” are useful wherever you live. Healthinsuranceinfo.net also has a concise guide on managing medical debt.
- Explore the resources for co-payment and other medical cost assistance.
Remember to reach out for help—medical debt understandably causes emotional stress and it’s important to get as much support as you can. Speaking with a counselor can help you manage some of your stress and come up with a plan so that you feel more in control.