Tips for Dealing with Hospital Costs and Medical Debt

Arriving at the hospital
If you're not insured, the hospital might ask for an up-front deposit. If you can't pay the required deposit:

• Negotiate the deposit amount to no more than 10% of your monthly income.
• Remember that, regardless of your ability to pay, a hospital can't deny you healthcare in an emergency under federal law.

Once you've received care
If you're uninsured or underinsured and you're unable to pay your medical bills:

• There are many types of financial assistance for people within a certain percentage of the poverty level. This percentage varies by state, so check with your state government.
• Of the hospitals that offer financial assistance programs, not all are forthcoming about them. Ask for a written copy of the hospital's financial assistance guidelines.

Getting financial assistance
To receive free or discounted care, you must show proof of your income, expenses and savings. This can include pay stubs, rent or mortgage statements, alimony, child support payments, utility bills, Social Security income, pension, food budget, debts, tax returns, unemployment checks, and bank account statements.

• Avoid being reported to a collection agency by asking the hospital to “hold” your case while it considers your financial assistance application.
• Ask the hospital billing office to discount your bill to the rate charged to a typical insured patient. You should not have to pay a hospital's highest “self-pay” rate.
• Some hospitals offer a sliding fee scale, which allows patients to pay according to income and family size.

TIPS
Setting up a payment plan
Some hospitals offer flexible payment plans for people to pay off their bills. Try to work out a payment plan that allows you to maintain your other monthly expenses. Be prepared to show proof of your income, expenses, and savings.

If you need to adjust your monthly payments, notify the office for help.

Understanding your hospital bills

• Keep every bill you receive.
• If your bills are not itemized, ask the billing office to give you a bill that details each charge.
• If you get several bills, it may get confusing. Ask the billing office to help you sort them out. Once you have a grasp on all the charges, ask the billing office to combine some or all of your bills into one payment.
• Ask if the hospital offers a patient liaison service to help you decode your costs and obligations.
• If you've overpaid on a bill, or want to prevent doing so, you can seek help from an advocate who specializes in such issues. Try http://www.billadvocates.com/.
• If you need legal assistance but can't afford a lawyer, consult your local Legal Aid Society.
• If your debt is sold to collections, read about your rights under the Fair Debt Collection Practices Act.

Crucial don'ts

• Don't ignore your medical bills.
• Don't sign up for a healthcare provider-issued credit card or high-interest loan to deal with your debt.
• Don't give up looking for help. If a hospital doesn't offer financial assistance, government programs can help.
• Don't sign a payment plan with an acceleration clause – this penalizes late payments by binding patients to pay the remaining debt in full.
• Don't sign an agreement that binds family members or legal representatives.
• Don't sign an agreement that makes you responsible for the hospital's collection costs.

Sources: www.legal-aid.org, www.credit.com, www.billadvocates.com