Nobody likes to get hit with surprise medical bills. You work hard to make sure that you’re sticking to your budget and setting aside money for retirement when all of the sudden you get a medical bill in the mail for hundreds or even thousands of dollars. It’s a real gut-punch that can be difficult to cope with, both emotionally and financially. However, it’s important to remember that you’re not alone and you do have options.
What should I do when I get surprise medical bills in the mail?
First of all, don’t panic. Look over every detail of the bill. Is it addressed to your exact name? Is anything misspelled? Do you recognize the facility, procedure, or treatment for which you are being charged? If not, it could be a mistake or even a scam. In short, always read the fine print and make sure that the surprise medical bill is legitimate before you proceed to the next step.
There’s a chance that you were sent one or more surprise medical bills by mistake. Most medical bills will come with contact information from the healthcare facility. If you feel that you’ve received a bill in error, you should contact the doctor or facility immediately to dispute the charges. Don’t assume that the bill is correct and start paying it down. If you do, you could end up paying a debt that you didn’t even owe in the first place!
If you can’t get through to the healthcare facility or can’t get any useful information, contact your health insurance provider. There’s a chance that there was a mistake on their end that led to a surprise bill. For example, you may have paid your deductible for the year, but this was not recorded properly by your insurance provider. As a result, the healthcare facility sent you the bill for the full amount, rather than your post-deductible portion.
I checked and the bill is correct. What do I do?
Even if there were no clerical errors and the bill is correct, you still have options. Depending on where you live, your state may have laws protecting consumers from surprise medical billing. So, if you live in one of the 25 states that currently have these consumer protection laws on the books, you can do research to see exactly how you’re protected and what you need to do to dispute the bill.
However, if your state does not have any kind of balance-billing laws, you will need to begin negotiating with your doctor, insurer, and the medical facility. In many cases, you can be charged a rate for a certain treatment or procedure that is well above the standard rate. Go through each item on your bill and see how much the procedure typically costs. You might be able to convince the facility or your insurance provider to bill you at the market rate.
Finally, once you’ve nickel-and-dimed everyone about the bill, you might reach a point when you can’t get them to go any lower. At this point, you will probably need to just pay the bill. Most hospitals and medical facilities allow patients to pay large medical bills in installments. This can ease the burden and allow you to pay the bill in smaller chunks over a period of time.
If you have a low income or disability, you may qualify for financial aid through the government or a charitable organization. Many of these programs are run at the state level, so you may need to check your state government’s website for more information. Additionally, you can learn about some of the most common medical bill relief programs at USA.gov.
I can’t afford to pay this surprise medical bill. What should I do?
Once you’ve exhausted all of the actions above, you still have one more option: appeal the bill. You can appeal surprise medical bills in several ways. First, you can try to make an appeal to your insurance company. Most medical bills include information on how to appeal the charges. If you can’t find this information on your bill, contact your insurance provider directly to formally appeal the charges.
It’s important to note that an appeal can take time, which may cause the doctor or medical facility to send the bill to collections. If you know that you want to appeal the charges, you should contact your doctor and inform them of the situation. You can ask them to delay sending the bill to a collection agency, however they have no obligation to do so.
Finally, if your insurance provider denies the appeal, you can also try to make an official appeal through your state’s insurance regulatory agency. You can find more information on your state insurance regulator through the National Association of Insurance Commissioners’ website.
If both of your appeals are denied, you still have options to overcome medical debt. Paying surprise medical bills may be difficult and frustrating, but if the charges are correct, you have few other options. Fortunately, many charitable organizations were founded to help people in your exact situation, so don’t feel like you’re alone.
How to avoid surprise medical bills
It may be too late to stop surprise medical bills that you’ve already received, but there are ways to avoid surprise medical bills in the future. Here are a few important tips to remember:
- Research Your Insurance Plan – The best way to avoid surprise medical bills is to know exactly what your insurance does and does not cover.
- Know the Laws in Your State – As previously stated, many states have laws protecting citizens from surprise medical bills. Make sure that you know your rights as a state resident.
- Consider Supplemental Insurance – If you have a basic health insurance plan with low premiums and high deductibles, there’s a good chance that you could get hit with costly surprise medical bills. Consider getting supplemental insurance to have greater health coverage.
The Bottom Line
Health insurance in the United States is complex and the responsibility to know your rights and coverage falls on your shoulders. Fortunately, if you receive a surprise medical bill in the mail, you do have options. The important thing is to remember that there are ways to protest illegitimate charges and lower the cost of legitimate charges.
In any case, if you have received surprise medical bills and would like to know more about your legal rights, check out our guide to free legal aid in all 50 states!