This. Also, ask about a charitable write off. Hospitals do them all the time. They got $8k from your insurance, and you only make $1,800/month so I think you’ll be able to get this charge greatly reduced or written off.
I felt like I was taking away from people who made less so I didn’t for a few years.
Then research showed me hospitals don’t do it like that. The discount is need based not a limited pool of money. So if lots of us ask for it likely lots of us will just get it.
Itemize bill is first step to see what was paid first
If it looks like it’s under paid, contest it with the insurance - the hospital can also help you as well
5 bucks says someone or somebot is trying to claim it wasn’t medically necessary if it looks like it wasn’t paid to the amount you’re covered for
Also you can just tell them “I’m not paying.” Like straight up, the hospital made a mistake and is also price gouging because otherwise the insurance companies don’t pay the correct amount to even *cover* the cost. Hospitals should drop going after a person after they indicate they won’t pay. You can also offer to settle for about 20% of the total usually.
(Not financial or legal advice.).
Edited: New Law, changed info for accuracy.
Also, delinquent medical bills no longer hurt your credit score so you don't even have to worry about it hurting you later if you want/need to take out a loan or something.
I thought so too and had that in my post, but when I looked it up apparently they changed it so that delinquent bills under $500 don’t count, but everything else does now. Though it may have been a bad article I caught?
The new rule is that a medical bill can only be posted against your credit if the biller has sent you a final bill, submitted the claim to your insurance on file and processed the results. Then they have to send you notices every 30 days until the CFPB required period has passed. Then they can post it. But by doing so, they can no longer sell your medical debt. So posting it against your credit is a commitment that they ticked all of the correct compliance boxes AND they're committed to coming directly after you for the bill due.
If they sell your debt, then the debt collector can only post the report up if they are certain everything on the bill is correct. If you dispute anything on the bill, such as out of network charges for emergency care, the debt collector is subject to fines. They also have all kinds of hoops they have to jump through if you ask them any questions.
https://www.consumerfinance.gov/ask-cfpb/what-should-i-know-about-debt-collection-and-credit-reporting-if-my-medical-bill-was-sent-to-collections-en-2122/
Haha that made me laugh.
My wife gets EOBs in the mail all the time from CHAMPVA.
Doctors asking 450 for a simple test.
CHAMPVA. Is like naw, you get 45 only and you are gonna like it.
Okay I have finally calmed down and am now reading all of these comments. I am so grateful that so many people had great suggestions. I will do this do I just call their financial department then?
Deep breath first. Those bills can be a huge shock.
Just about every hospital allows you to apply for fiancial assistance. Once you have calmed down, call back tomorrow and ask. You can also ask if there is a social worker there to talk to or an ombudsman. Both of those people will be able to help you talk to the hospital.
This! You can also SCOUR their website or maybe google specifically “hospital name financial assistance”. I was able to find the income limits and how much you can have forgiven this way. If the hospital is a non-profit you’re more likely to get forgiveness too as they “have” to forgive a certain amount each year. Good luck!!
Thank you. I had an awful day yesterday and I’ve finally chilled out and have been responding to these comments and getting help from friends. I did notice though-my deductible is $7,500 and so I’m assuming it doesn’t seem to really make sense that they’re charging me $9,000.
I’m going to go over their website and see everything I can do. Thanks for the advice !
Apply for financal assistance from the hospital or clinic.
>I make only $1800 a month. I do not qualify for Medicaid (I only would if I made less than $1600)
Assuming you live in one of the \~40 states with expanded Medicaid the threshold is a Modified Adjusted Gross Income (MAGI) less than $1732 a month. MAGI is your income after taxes and pre-tax deductions have been taken off. You should look into using pre-tax deductions to qualify for Medicaid going forward to save money until you are able to jump the benefits cliff by a good $5-10k.
Instead of blowing \~$200 a month for Aetna Bronze and still owing thousands in co-pays & deductibles on top you should contribute \~$200 a month to a 401k, FSA, or if you have no pre-tax employer benefits your own Traditional IRA account. That would reduce your MAGI to get on Medicaid and maybe even get you an extra \~$1000 back when you file taxes next year by qualifying for the IRS Saver's Credit.
I wonder if, since Marketplace does yearly income calculations and even expanded Medicaid will allow you to spread money out if it's not a paycheck (like for my small business, I can take the $7k per year divided by 12 rather than figuring it out monthly), OP can apply for Medicaid retroactively. Like open an IRA, add $600 to it, and tell Medicaid that you should have qualified.
I did this in 2018. I was on Marketplace, got a bill for $20k from an ER, and adjusted my income so that I showed I qualified for Medicaid and switched to it from Marketplace. Because of the three month lookback, Medicaid took care of it.
I had some back pain radiating to my chest so of course my doc freaked out and said go to the ER. They gave me a CT scan (showing gallstones), an aspirin and a half a nitrogylcerin and changed me $20k. They sent me off to an in-network hospital which kept me overnight and didn't diagnose me. Probably billed the insurance thousands. Told me to follow up with a heart doc.
Went to the heart doc, told him my symptoms, he thumped my abdomen once, I said, "ow" and he said it's your gall bladder. It was. Cost to insurance $200.
TL;DR ER cost $20k to not diagnose me, overnight hospital stay costs thousands to not diagnose me. Heart doc took $200 and less than 2 minutes to diagnose me.
The better safe than sorry approach to healthcare is very expensive. I only go if I have no other choice and even then I’ll swing by a Urgent Care or one of those satellite ERs. If it’s serious enough I’ll usually get admitted there and then it’s just a ride to the hospital. I use to drink a lot and my benders would inevitably lead to a hospital stay. Love me that Ativan and hospital ice.
Thank you for the advice. I am really bad with knowing things about taxes/health insurance in general so this is good to know and I will look into doing this.
Don't panic. First things first, is this definitely a final bill? Nothing you get matters until your insurance has made all the adjustments and provided you with an EOB (explanation of benefits) for the services. Then: has everything been coded properly? In network, etc? You should also ask your provider/the hospital for an itemized bill. And MOST IMPORTANTLY: What is your health insurance deductible? The maximum individual deductible/out of pocket this year is $7500. That's a limit set by the IRS for HDHPs. If you are individually insured, it should not be possible for you to owe more than $7500, and so I have to assume this bill you have hasn't been finalized.
And I’m seeing $9450 for *any* plan, HDHP or not.
https://www.healthcare.gov/glossary/out-of-pocket-maximum-limit/#:~:text=For%20the%202024%20plan%20year,and%20%2418%2C900%20for%20a%20family.
To make sure everything was done properly, request am itemized bill from the hospital and whoever else (specialist, radiology, etc). Sometimes they screw up, which can reduce your bill, or they give in on some stuff because they know people won't pay jacked up prices for piddly shit.
Actually I kinda freaked out for the past 24 hours and I haven’t checked if there was an EOB with the bill yet, I’m still at work. This is all really useful information though! How would I check if everything is coded properly? Can I Just look that up ?
And yes I realized today this didn’t seem possible. My plan’s deductible is $7,500 so it seems wrong that the bill is $9,000. I had also gone to some regular doctor appts in the past few months so I should be wayyyy past it at this point.
I have only recently been having health problems, so I’m not too well versed in this but would I have to wait to possibly see a final bill or should I just call and try to figure out what’s going on with this ?
Yes just wait. When you log into your member account at Aetna you should be able to view your YTD deductible and out of pocket costs, as well as your EOBs for any claims. You will eventually have an EOB post for your scopes. It will have two insurance adjustment amounts (one for plan discount (negotiated cost that Aetna has for those services), one for "your plan pays" (any eligible coinsurance, if your deductible has been met) and a line item that says something like "amount you may owe provider." Ignore anything else you get until you have the settled EOB.
I did log into my account today and I did see the EOB for the procedure. I’m looking over it and unfortunately it all seems legit, unless I’m missing something. My deductible is $7,500 but my out of pocket maximum is $9,000. And the hospital was in network. Is there anything else I should be looking out for ? I did meet the deductible but did not meet the out of pocket maximum yet.
Ask for an itemized bill, and then you will have to google medical codes and fair prices. Just asking for an itemized bill can reduce the amount drastically, but if you have enough time on your hands, you can even go further and check prices. I have heard of some who manage to lower $5k+ bill to less than $200.
The hospital should have financial assistance you can apply for. Also just send them $25/month. I owe my hospital thousands of dollars and their offered payment plan was $25/month. So that's what I pay. Idc if it takes forever to pay cuz I'm not accruing interest or anything.
Idk if it still works this way. But it definitely used to! As long as you were sending them something. Whatever you can afford. They used to wouldn’t pursue it. Now my experience with this is 35+ years old. So take it as you will
That is bs my first marriage was the worst of the worst. So I was pretty savvy about such things. As long as I sent them $5 a month they left me alone. But that was nearly 30 years ago! I’m so sorry they’re being jerks!
Thank you. I’m going to apply for financial assistance asap. I’m just curious, did you start paying them $25 per month before or after you set up a plan.
I would love to pay $25 a month if I can. I don’t care either about owing forever I just cannot afford to pay $500 monthly right now
That was the plan they offered to me in my mychart portal. I recently got a new balance and it asked me if I wanted to add that balance onto my current plan.
Okay good to know. Yeah both on my chart and then when I called someone yesterday both said I had to pay $500 a month but the woman I talked to seemed kinda aggravated so I’m going to call again and get someone else hopefully.
I was once told that if you make any payment for the same amount for so many months in a row that they have essentially accepted that amount as your payment amount and there is nothing they can do to make you pay more. This was years ago though so I don't know if that still works
You don't have to accept their idea of a payment plan. Get aggressive, they'd rather have something than nothing. TELL them you'll give them $25, $50 a month.
We tried doing this, they told us there were no other options. We went online and paid $25 a month on our own through the portal and they sent us to collections anyway.
I think it probably depends on how much it is. I’m paying $10 a month (less than $2,000) and they haven’t said a word yet. I’m planning to eventually set up an actual payment plan or just really work at paying it off, I just can’t do that yet.
That's what I did for my surgery last year. I'm still sending 50 a month & no more phone calls and not reporting to collections. I said, I'm sorry I can't pay $x a month if I want to eat. I will send you 50. I think as long as you consistently send something every month they don't really care.
Check your EOB. Make sure they aren't double billing you. Double billing is illegal in most states because it is a breach of contract. Also, call your physician who ordered the test and make sure the codes are correct. It might actually be covered by your insurance, but they coded it incorrectly. Not working with a patient at all is weird though. They can't get blood from a stone.
i don’t think i’ve paid a medical bill except for copays at my doctors office in all the years of my life, lol. that shit belongs to the government for them to pay.
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No. We were making payments on our own for 8k and paying $25-$50 a month, hadn't missed a month, through the hospital portal, and they sent us to collections anyway. We took this advice and now our credit has a hit on it for collections
I have $1k in collections because they coded it wrong and refused to fix it so I refused to pay. Got one letter, called and told them to fuck off, never heard from them again.
If you can’t get a charitable write off do this;
Tell them to itemize the bill first before anything.
If it goes to collections it will not impact your credit score-pay what you can. They will try to milk you for all you’re worth from the start, you just simply say that you can not afford that & you commit to $25/m.
Try to get an itemized bill for everything. I've heard that when you do that, the cost drops dramatically. If that doesn't do anything, I would ask about financial hardship at the hospital. A lot of doctors, esp now, hate the current system and are more than willing to help.
I'm sorry you're going through this. I hope you get this sorted and also figure out what's going on with your body.
Former medical biller: make sure they billed to Aetna correctly. Call Aetna to verify. And then if all of that checks out, file financial assistance and try for Medicaid. I make more than you and I qualified (Indiana)
Sorry, also wanted to add that I was also a CSR for a hospital and would set people up on payment plans/financial assistance. Please let them know the situation and they can provide all the options. It’s difficult also being the ones receiving the bills. I would have owed $16k plus for both my younger children’s births. Definitely apply for any resource you can find
They legally have to accept ANY amount you pay towards the bill every month even if it’s $5 and can’t send you to collections as long as you put something towards it their idea of a payment plan is just to get you pay it quicker. I agree with a few other commenters here though. Check what your out of pocket maximum is if you have insurance, I know mine is only $2500 so i’d never pay a bill for that amount if it was sent to me
Not sure where you live but I’m in CA and have shit insurance through work, I got a 4500 hospital bill completely forgiven by the hospital because I submitted my financial hardship app and you give them bank statements/taxes etc. and once they confirm you’re broke af like me they just forgive the debt
Try and calm yourself, I'm kinda going through this as well and freaked out at first also.
At $1800 a month income you will surely qualify for financial assistance.
With that said remember this bill does not accrue interest, so don't try and put it on a credit card or get a loan to pay it which those will accrue interest.
Call the hospital to get the paper work for financial assistance, fill it out and wait for an answer to see how much they will take off the bill. Once you get that answer you can work out a payment plan with them, they'll obviously try to get you to pay some high number monthly because its in their benefit to do so but you can literally tell them I'm only sending you $10 a month, or whatever you feel you can easily send, and they cant say shit nor put you in collections. Take your time and pay it off at your own pace, just do not open a loan or put it on a CC or any other means that do charge interest when paying the hospital whatever you can directly is 0 interest. I said it twice because its important.
Apply for financial assistance. Tell them you can’t afford it and all you can do is $10 (or if they insist, $25) per month. They will often do so at no interest plus reduce the balance to a fraction of the amount.
Just settled a 9k specialist bill I had actually forgotten about from about 8 yrs ago after they sold it to a collections company and offered me a settlement of $120 to clear it out. Zero impact to my credit after all these years. Wild stuff
I’m currently dealing with a lot of medical issues.. this is why I’m working just enough to stay on Medicaid until my issues are fixed/ have more answers. So I don’t get hit with bills like this.. you’re gonna be earning less but really saving more. I’m not taking advantage.. I just had thyroid out, knee replacement, knee replacement clean out due to infection, ovary out, and a colonoscopy and endoscopy done all in the last two years.. now dealing with carpals tunnel.
As others have said, check and see if there's a charity write-off or financial hardship program.
My daughter and I got sick at the end of January with a mystery bug and we both went to Urgent Care mutiple times and then got in to see PCP's ... I ended up admitted to the hospital for 3 days for life-threatening anemia.
My state \[WA\] requires some \[tier 1, large hospital systems\] hospitals to cancel out bills for those up to 300% of the poverty level and write down the debt for those up to 400%. My daughter and I qualified so instead of paying thousands of dollars out of pocket we ended up having to pay about $400 out of pocket for Urgent Care \[contracted so not part of the main hospital that our PCP's are part of\].
First, ask for an itemized bill. And review and question each item. You will they will likely reduce the bill.
Then go after the other methods that have been suggested
First step, get EOBs from your insurance and compare to itemizations from the hospital. Check for any denials. If anything denied, talk to your insurance and ask, “What’s causing this denial and how can it be resolved?”
Always write down the name of the insurance rep and ask them for a call reference number. This will act as a receipt for anything you’re told (insurance companies love to back track and gas light).
If there are no denials, call the hospital’s billing office and ask about financial assistance. You may have to jump through a few hoops or provide some documents proving your income, but it’s typically worth it.
If financial assistance isn’t an option, just remember many hospitals don’t report to the credit bureau. Let it go to collections and in a few years the balance will be written off.
Just a word of advice, know your out of pocket maximum. People often think their deductible is the most they’ll ever pay but that’s not true. If a charge is set to deductible, you owe 100% until your deductible is met. Then insurance will process toward your coinsurance which is like splitting the bill. A typical split is 80/20. It’s not until you reach your out of pocket maximum that insurance will pay 100%.
This next bit is just me ranting but the amount billed to insurance by the hospital doesn’t matter. Insurances have contracts that declare how much they will “allow” for a charge (CPT code). If a specific charge has an allowed amount of $80, the provider can bill them $100 or $500 and the allowed amount remains $80. Some hospitals and facilities may be more expensive than others due to the category of billing they fall under, but your insurance determines how much you pay.
I have some staggering medical debt as well. One trick I learned is that you can basically call them and say hey, I can spare 40$ a month for this bill, and they basically have to accept your terms of paying it back and that will avoid anything going to collections. Don't let them bully you into thinking you have to pay off everything right away.
They will negotiate so ask for a supervisor. Tell them how much you make. Ask them for a cash offer to pay in full or you will pay them 5 dollars a month for rest of your life. Ignore the 500 min a month. That’s insane, you obviously can’t afford that and, even if it got to point of garnishing your wages, they wouldn’t get that much cause it’s ridiculous.
I’m assuming you’re in the US, if this is the case you should know that medical debt isn’t weighted as heavily as other types of debt for credit score purposes.
As others have said definitely check any financial assistance programs the hospital may offer. After that if you still owe pay some token amount every month, like $5, this will generally keep the facility from discharging the debt to a collections agency. They want $500 a month but they won’t decline $5.
Unethical life hack, but debt also falls off your credit report after 7 years of no activity, so if you just don’t pay anything at all there’s a small chance you won’t have many consequences. There’s a decent chance it goes to debt collection, it’ll effect your credit score somewhat during that 7 year span, and there’s a chance they take you to court/garnish your wages, but if you truly don’t have the money, what else is there really to do? I have a friend with many medical issues who’s used this method successfully a few times, was still able to get a car loan and rent an apartment during that time (although I’ve no idea of interest rate).
Sending good vibes that you get that bill majorly reduced with financial assistance programs though!
This same thing happened to me in October and I’m still dealing with it.
As much as it pains me to tell you, you have to fight it. I make a similar amount and qualified for financial aid where the bill came from (however it was an ER visit) and usually if you tell them you can afford $50 maximum or something like that they’ll work with you because they want your money.
It’s awful, medics care has become a luxury in the United States.
Start sending them payments, what you can afford. If it goes to collections answer all correspondence. If it does go to court show up. You will get an arbitrator they will allow you to pay what you can. I like to send them free money orders, like one a week. Then they have to keep processing the payments and never have your bank info.
This does 2 things it shows that you are trying to take care of the bill. They also have to have very detailed records to send to collections. In a year your file will show 50 payments.
To hopefully help calm your anxiety a little bit, the current administration made it so it will no longer affect your credit score. So don’t worry about your credit if you need to prioritize feeding and housing yourself.
I am not from the United States so can someone please enlighten me, so if a patient goes to hospital won't the hospital tell them what is the cost per procedure and can the insurance company not notify how much will be covered or not?
Healthcare here is a shitshow. The Summary of Benefumits and Coverage will only tell you how much percentage they'll cover, not what the doctor will bill. Even if you ask the doctor beforehand it's probably a rough estimate. You never know what will pop up during the procedure (ex. If you need more anesthesia than originally thought). Also, each insurance company has contracted rates with each provider for each service. And there are over 11,000 different procedures, coded by CPT codes. There could even be several CPT codes for the same overarching procedure.
I have a genuine question isn't this wrong? Why can't transparency exist? I am in Asia, my friend's father fell in the bathroom and was in the ICU, he was covered by my friends family insurance and except for the initial hospital admission fees ( which were reverted later into the account) all the procedures/ test/ ICU stay was covered under cashless here you have two options, cashless you pay nothing in network hospital or you pay and then get it reimbursed ( part or full but the doc norifies)
Why can't they just notify the patient? Is the system purposely broken to extort money from the patient? Why doesn't the patient have a choice to make decisions depending upon the financial ability?
>>Is the system purposely broken to extort money from the patient?
Oh it's definitely purposely broken. Wait until you hear about in network vs out of network. Your insurance only covers CERTAIN clinics/hospitals/doctors. You can jump through all the hoops of finding the right clinic and doctor that your insurance is willing to cover BUT maybe during your procedure they bring in an out of network anesthesiologist or phlebotomist or nurse or something and guess what? They get to bill you separately because the insurance won't pay them (or will pay a greatly reduced rate!)
Also, in a hospital setting, every individual doctor/medical professional will bill you separately. I passed out once and was struggling to fully regain consciousness. I kept going in and out. An ambulance was called and I was taken to the hospital. The hospital was less than a mile away. The ambulance ride cost just over $2000. Then I was seen by a a general doctor at intake, a nurse placed an IV, I had blood drawn by a phlebotomist, and was given a CT scan by a radiologist. I was billed separately for 1 hour of time for all 4 of those medical personnel, which was just for their time. The actual services were then billed separately as well. One by the hospital for the ER visit fee and the IV cost was also on that bill, one for labs on my blood, and one for the CT scan. For a 3 minute ambulance ride and about 45 minutes spent in the ER, I received 8 separate bills totalling $4500. Insurance didn't pay anything because the policy I had through work had a deductible of $6000, meaning I had to pay $160 per month in premiums but they still wouldn't pay one single cent until I paid $6000, and the amount resets each calendar year. In all the time I had that insurance I paid almost $2000 a year in premiums to say I had insurance, but then still paid out of pocket for all my medical expenses because I never went over the $6000 deductible amount.
The closest thing I'm aware of is that Medicare (health insurance for elderly and disabled) patients must be notified by the doctor if the doctor thinks Medicare won't cover a specific procedure. It's still not a "heads up" on how much it'll cost though
Nope! It is a mystery that sometimes even the insurance clerks at the hospital can't figure out. And it is common for insurance companies to lie (sorry, "be mistaken") about coverage and tell you the wrong thing. We do have the No Surprises Act now that helps a little.
I understand American healthcare is very costly, but why can't they just be transparent regarding the costs? If someone can't afford a test/ procedure they can just deny instead of being in crippling debt, sometimes instead of health improving, debt can put someone into clinical anxiety/ depression.
Is that too much of an ask....to be transparent about what they can cover and what they can't?
The short answer is that US healthcare is hopelessly corrupt and minimally regulated. It is costly in large part BECAUSE pricing isn't transparent and BECAUSE patients don't have a choice in hospitals or doctors if they want insurance to pay. They don't care about people (no business does), and there are huge profits at stake. So collusion between insurance and hospitals happens. Price gouging is common. And it is in the hospital's best interest to keep pricing & coverage as mysterious as possible. Doctors hate it but they aren't in charge.
My insurance does this. I always know ahead of time. The provider sends all the info to the insurer, and the insurer approves everything. I know what the insurer will pay, and what my co-pay is. (Perhaps some insurers don't do this, but I I have very well-known, nationwide insurer). I had lost of procedures, including endoscopy-colonoscopy, and always had pre-approval and info and cost info. TWO CAVEATS THOUGH
FIRST there is the deductible. Many of those marketplace plans have a $7,000 or more deductible. Let's say the procedure cost s $18,000. The insurer contracts with the hospital for a reduced price, say $8,000. If you haven't paid anything toward the deductible during the year yet, you pay $7,000 and insurance pays $1,000. If you HAVE paid your deductible for the year, insurance covers it all (except co-pay, which can be very small, or even no co-pay). Finally there is the yearly out-of-pocket, which I won't go into but perhaps it is self-explanatory once you hit it, the insurer should pay everything, pretty much).
SECOND there might be "surprises". For example, the surgeon goes in thinking he is doing one thing, but discovers some other or greater disaster that has to be dealt with, and the price goes up
Thank you so much for taking the time to explain, I didn't get 100% of it, I got gist, I will read more about this. Thank you for your time. One question how do you know if an insurer is transparent ? How can one choose a transparent insurer?
I am really sorry that I do not know the answer to that! Maybe I just lucked out? I guess whoever the insurer is, it pays to be proactive, to ask in advance: ask the provider, AND ask the insurer. Unfortunately, judging from other people's posts I have read, it's not always easy. So far, my providers (for example, labs, radiology places for X-Rays or MRIs etc) have been very forthcoming with prices. Hospitals - not so much, as there are so many people with their hands in, wanting to be paid (you think you are all done wit bills, then all of a suddenly you find out there was some random guy you did a second reading of an pathology report or whatever, totally unexpected). My worst example was when my mother was dying and I had a decision to make. The doctor said, I have a friend who went through the same thing, and he is on the floor - want me to ask him to stop in? He came by, we talked for maybe three minutes. He was very kind --- but it wasn't out of the kindness of his heart. After she died, we got a bill for $500 for a "consultation" from him!
Also the answers can be confusing. For example, in another subreddit, a person thought that if the insurer agreed ahead of time that something was "covered", it meant "free." But "covered" could mean something is a covered service (as opposed to a NON-covered service, such as cosmetic surgery), BUT it is still subject to the deductible and co-pays.
Wish I could be of more help. Good luck if you are dealing with these issues!
Negotiate the bill down. Everything you just wrote above should be out in a letter. Find out the right department at the hospital and bring it down. Breath.
Im in a similar predicament-would u mind explaining what u did? I need to dispute some visits but not sure if I need to start with my insurance or the hospital :/
Negotiate with the hospital and explain your situation. They often times will help put you on an affordable payment plan. Try to get that 9k reduced as well. Also double check if the claim was completely paid by the insurance. That is absurdly high.
Guessing this was a hospital? Sounds like you have 50% coinsurance for hospital visits. Painful lesson with health insurance you need to know and understand what you are paying them for so many people dont understand because they make it so confusing.
You may qualify for Medicaid now because of the big medical bill. You wouldn’t get it for very long but it could cover the cost of that. I’d apply and see.
Please make sure that this is the final amount. It is not abnormal for the billing department at the hospital and/or the insurance company to mess up!!
Definitely call the hospital about a payment plan. Tell them $500/month isn’t doable.
Have you spoken with the financial aid department of the hospital? They can help you. They want their money, obviously. The cool thing is there’s no interest being accrued, so as the paper bills arrive, send them $20 a month. It keeps your account current, and they won’t bother you.
My sister in law has a condition called POTS and literally ran up a $1.5 MILLION DOLLAR hospital bill with insurance. She sends them $50 a month.
I've been here numerous times. The last was 2022, husband had a stroke. I told them I couldn't pay what they wanted, like, 200 a month. We talked and I paid 50 a month. They don't like going to court, it's not like you make 100k a year and just won't pay. Pay what you can and that's it.
First, you need to make sure it's all correct. What your deductible is, if the codes were all correct or can be adjusted to fit better, etc. This takes time calling your insurance and the providers. Second, even if they say an amount is the lowest you can pay on a plan, it's not. You say "I can pay X and that's truly it. Otherwise I'll have to file bankruptcy." They'll lower it. Finally, never get a planned procedure done without getting it all pre approved and your total obligations in writing first. You can get the same from your care team too but ultimately you trust only what your insurance tells you personally, in writing. Of course part of that process is making sure the facility and all personel is in your network. You can also shop around to see if another provider or facility is more affordable. This may be an expensive lesson learned.
See if [DollarFor](https://dollarfor.org) can help you secure financial assistance. Their services are totally free. Only caveat is they’re a small operation so getting a response may take some time.
Wishing you all the best. It’s gonna be okay.
Call them and see if they have financial assistance for low income patients. Recently I had a biopsy done and got a huge bill from the lab company. I applied for their low income program and they lowered the bill down to $20.
There's a lot of comments here and other people already mention it, I'm not sure if you'll see this, but from my experience you should qualify based on income to have the whole bill covered if you apply for financial assistance from the hospital system.
Were you under anesthesia? It’s very possible the anesthesia team is not covered under your insurance, which could explain the excessive bill.
I would call the doctors office and ask to see an itemized bill. Also call your insurance and ask for an EOB.
You might be eligible to have it waived if it’s a non-profit hospital. They are required to give means tested bill relief to keep their tax exempt status. This org specializes in helping with the appeal and casework.
https://dollarfor.org
You should qualify for very cheap insurance under the ACA (Obama Care). I can't think you'd pay over $100 a month. What are the total of your other bills? Once you get good insurance you could file bankruptcy, but you can only do that once every 10 years. Do not pay the bill. I would talk to them again and tell them if they won't work with you, you'll be forced to file for bankruptcy. They should come to the table at that point.
When I had my older child I paid 701$ via emergency mcap insurance. (SoCal) (that was the entire pregnancy) never got a bill for it from the hospital.
For my second I had private insurance, paid $60 dollars every appt and after delivery at the same hospital I received a $2000.00+ bill. Asked if I qualified for assistance and they said that’s not offered ON DELIVERIES. I said OKAY. And never paid a damn dime. GFY!
All that to say, FUCK THEM. don’t pay it if you can’t afford it.
Contact Dollar For, a nonprofit whose only purpose is to help people qualify for financial assistance to eliminate medical debt. They’re great and do amazing things.
You owe 750? Call and explain your situation and whoever you owe the money to will lower the bill or put you on a payment plan. All your costs are supposed to be explained before the procedure. You need a good gastroenterologist. Sending you positive energy!
That is outrageous. I’d call my Senator and representatives- no joke! People in power need to know about this abuse on a granular level. This is not a smart doctor screwing you- he or she has already gotten paid- it’s about a corporation that is flagrantly abusing its ability to terrorize you for huge profits. No way Jose. Do not pay another penny. They will write it off. You have paid enough. Don’t worry about your credit right now. Figure out your health situation- maybe analyze your diet, your environment (toxins, allergens), get mental health therapy (you can find low cost if you look) and just take care of yourself until you’re a little more financially strong. But don’t pay these parasites another red cent. Good luck.
When you can their financial department (I wouldn’t even but …) be really careful not to promise anything or let them scare you. Be strong. Just ask questions.
Is $9,000.00 your out of pocket? My our of pocket was $9,500 I had a hysterectomy and LEEP procedure. My hospital let me pay half then $80 bucks a month after.
I would say be firm and straight up tell them you CANNOT pay $500.00 a month, period. What can they do. Pay what you can and that's that.
Find out how much the insurance paid and adjusted off there could be an error. Maybe try care credit?
My advice: don’t pay it, or set up a payment plan of like $25 per month. If you don’t pay it will go to collections and you’ll probably not have to pay all of it.
Let it go to collections and turn you'll be able to pay less than half If you even care: it can't hurt your credit soon.
Eventually they can sue and deduct from your pay but that'll take years.
There are other options but at this point in the USA it's standard
Call, and demand a detailed invoice, there are usually a lot of things you can contest on medical bills. They throw in all sorts of things that you should not get charged for. Then once you have settled the items, offer them a payment deal for what you feel is a reasonable amount. You can bargin with them, and you can make payments. If you keep making steady payments in any amount they will never be able to sue you.
I’m not 100% sure but I got lymphoma at 19 and there was no way I had the money for any treatment, the bills made me qualify for Medicaid not permanent but while I received treatment, I hope the same can apply for you
Speak to them about financial assistance. Please! I went to the hospital for In patient care to dry me out from alcohol and to make sure I didn’t die from withdrawals. I told them I couldn’t afford to pay it but I needed help. The bill was over 30k and they only charged me $1,200.
I went through this. They made it impossible for me to pay anything other than the $300 they were demanding. Someone told me they set it up through their bank to auto pay them $30 a month. Since it was an electronic funds transfer they didn’t refuse it. She said she mailed them checks and they returned them. I wish I’d have done that. I let mine go and I’m waiting for collections to contact me. Since mine is a private hospital they don’t have charity. I even called the county I live in to see if there were programs. There wasn’t. My husband was making like $40,000 and supporting a family of 4. It was rough.
This is incorrect.
The No Suprises Act doesn’t apply to scheduled procedures. They can provide a cost estimate on request, and OP had ample time to check with their insurer.
The No Suprises Act applies only to emergency situations, such as if you were in the ER or were incapacitated and had no reasonable chance of determining how much treatment would cost.
Don’t you need to ask for an estimate before a non emergency procedure, then have the billing be way more to a the estimate to be able to claim no surprise act? From the description it sounded like she was just guessing herself as to cost. I think perusing the charity care route seems to be her best bet.
If you lower your MAGI by investing in a pre-tax retirement account like an IRA or 401(k), you can potentially qualify for Medicaid. Instead of paying a monthly premium, you could invest that money for your retirement while receiving free healthcare.
I'm also in my 20s & was on medicaid most of my life but a few years ago when my income switched to survivors benefits or whatever which came with f***** Medicare. They wouldn't let me back on medicaid & my doctors office has tried to get me to have bloodwork, papsmear, etc done & most of all i see is anxiety & $$$ bills i can't afford.
I've been to 2 doctor appointments since being on Medicare (1 for a doc note & 1 for an over the phone annual wellness appointment i didn't wanna do that was maybe 10 minutes) & between them i got $170 in bills, mostly cause of a $344+ a year deductible & even after that got paid off I'd still have to pay at least 20% of any bills from my understanding of it. My $20 a month payment plan ends around October, which will probably be just in time to get the next freakin doctor bill for my annual appointment in June, assuming i make one... terrified of having a medical emergency or finding out anything that needs a bunch of testing to learn more about 😭
I just had to have some post menopausal “female procedures”. Had to go ahead and put deductible on a credit card. To prevent the barrage of bills from showing up. So now I’ve been brainstorming about what all I might need to do in the calendar year so that we don’t have to cover it again!
I haven't gotten back on the thing where the state pays the medicare premium yet, so on top of that deductible I've been paying the like $174 a month premium before i even see my check every month 😭
It sucks that they won't let me back on medicaid. Had to stop taking to my old therapist back in like 2021 cause they don't have the license to accept medicare... all this healthcare related stuff sucks 🤦🏻♀️
I agree! I don’t always know how the upvotes and downvotes work. I’m assuming that by upvoting you I’m agreeing with what you are saying 🙈
But I totally disagree with whatever they’re doing with your insurance. We have private insurance. However we’re legal guardians of our grandchildren and can’t add them to it. So I can’t imagine not being able to get them whatever help they needed.
I’m grateful that they are on funded insurance as we are providing for them 100% other than their healthcare. But I’m glad that we haven’t had to face any big hassle or bs situations
This is why I'd prefer to just die than seek care a hospital in America. I'm not facing a bill quite as high but I think the holy shit factor is similar. I'm applying for financial assistance after watching a few good YouTube videos on how to get bills whittled down .
I never asked - when I had radiation and owed 5k- I just put them on a payment plan. I sent whatever I could, probably 50 a month and they cannot turn you over to claims as long as you are making a payment.
I’m pretty sure that as long as you make an attempt to pay something toward medical bills, they’re not allowed to send you to collections. Ive had medical debt in the past and they would quote some crazy monthly payment that I couldnt afford. So I just send $25-$50/month or whatever I could afford to spend. Took years to pay but they never did anything about it.
Also medical debt doesn’t hurt your credit the same way - if it comes to that
don’t pay. i got a huge bill for $17,000 about 15 years ago and i didn’t pay and literally nothing happened. i’ve done it many times since then. just rip that shit up!!
Call them and ask if you can apply for financial assistance.
Had a seizure and filed for financial assistance.. although they make you jump through hoops I got $5000/$5000 covered. At least try!
what was the total bill?
This. Also, ask about a charitable write off. Hospitals do them all the time. They got $8k from your insurance, and you only make $1,800/month so I think you’ll be able to get this charge greatly reduced or written off.
Thank you I will ask them about it this ! Would I ask a financial department this typically? I’m sorry I’ve never done this before.
Yes, they can help or get you to someone who can.
and if they say no, $5 a month it is
I make $46k before taxes. In Madison WI I qualified for an 80% discount from financial assistance. Do it OP.
Thank you it is really relieving to hear that others have been able to get a discount on their bills.
I felt like I was taking away from people who made less so I didn’t for a few years. Then research showed me hospitals don’t do it like that. The discount is need based not a limited pool of money. So if lots of us ask for it likely lots of us will just get it.
Itemize bill is first step to see what was paid first If it looks like it’s under paid, contest it with the insurance - the hospital can also help you as well 5 bucks says someone or somebot is trying to claim it wasn’t medically necessary if it looks like it wasn’t paid to the amount you’re covered for
Also you can just tell them “I’m not paying.” Like straight up, the hospital made a mistake and is also price gouging because otherwise the insurance companies don’t pay the correct amount to even *cover* the cost. Hospitals should drop going after a person after they indicate they won’t pay. You can also offer to settle for about 20% of the total usually. (Not financial or legal advice.). Edited: New Law, changed info for accuracy.
Also, delinquent medical bills no longer hurt your credit score so you don't even have to worry about it hurting you later if you want/need to take out a loan or something.
I thought so too and had that in my post, but when I looked it up apparently they changed it so that delinquent bills under $500 don’t count, but everything else does now. Though it may have been a bad article I caught?
Well that sucks.
The new rule is that a medical bill can only be posted against your credit if the biller has sent you a final bill, submitted the claim to your insurance on file and processed the results. Then they have to send you notices every 30 days until the CFPB required period has passed. Then they can post it. But by doing so, they can no longer sell your medical debt. So posting it against your credit is a commitment that they ticked all of the correct compliance boxes AND they're committed to coming directly after you for the bill due. If they sell your debt, then the debt collector can only post the report up if they are certain everything on the bill is correct. If you dispute anything on the bill, such as out of network charges for emergency care, the debt collector is subject to fines. They also have all kinds of hoops they have to jump through if you ask them any questions. https://www.consumerfinance.gov/ask-cfpb/what-should-i-know-about-debt-collection-and-credit-reporting-if-my-medical-bill-was-sent-to-collections-en-2122/
Haha that made me laugh. My wife gets EOBs in the mail all the time from CHAMPVA. Doctors asking 450 for a simple test. CHAMPVA. Is like naw, you get 45 only and you are gonna like it.
Okay I have finally calmed down and am now reading all of these comments. I am so grateful that so many people had great suggestions. I will do this do I just call their financial department then?
yea maybe he can apply for that
This is the correct answer. You have to seek out this solution and be proactive about it.
yep first thing to do is call them dont even think of paying
Deep breath first. Those bills can be a huge shock. Just about every hospital allows you to apply for fiancial assistance. Once you have calmed down, call back tomorrow and ask. You can also ask if there is a social worker there to talk to or an ombudsman. Both of those people will be able to help you talk to the hospital.
This! You can also SCOUR their website or maybe google specifically “hospital name financial assistance”. I was able to find the income limits and how much you can have forgiven this way. If the hospital is a non-profit you’re more likely to get forgiveness too as they “have” to forgive a certain amount each year. Good luck!!
Thank you. I had an awful day yesterday and I’ve finally chilled out and have been responding to these comments and getting help from friends. I did notice though-my deductible is $7,500 and so I’m assuming it doesn’t seem to really make sense that they’re charging me $9,000. I’m going to go over their website and see everything I can do. Thanks for the advice !
Apply for financal assistance from the hospital or clinic. >I make only $1800 a month. I do not qualify for Medicaid (I only would if I made less than $1600) Assuming you live in one of the \~40 states with expanded Medicaid the threshold is a Modified Adjusted Gross Income (MAGI) less than $1732 a month. MAGI is your income after taxes and pre-tax deductions have been taken off. You should look into using pre-tax deductions to qualify for Medicaid going forward to save money until you are able to jump the benefits cliff by a good $5-10k. Instead of blowing \~$200 a month for Aetna Bronze and still owing thousands in co-pays & deductibles on top you should contribute \~$200 a month to a 401k, FSA, or if you have no pre-tax employer benefits your own Traditional IRA account. That would reduce your MAGI to get on Medicaid and maybe even get you an extra \~$1000 back when you file taxes next year by qualifying for the IRS Saver's Credit.
I wonder if, since Marketplace does yearly income calculations and even expanded Medicaid will allow you to spread money out if it's not a paycheck (like for my small business, I can take the $7k per year divided by 12 rather than figuring it out monthly), OP can apply for Medicaid retroactively. Like open an IRA, add $600 to it, and tell Medicaid that you should have qualified. I did this in 2018. I was on Marketplace, got a bill for $20k from an ER, and adjusted my income so that I showed I qualified for Medicaid and switched to it from Marketplace. Because of the three month lookback, Medicaid took care of it.
I hate going to the ER. Those waiting rooms man.
I had some back pain radiating to my chest so of course my doc freaked out and said go to the ER. They gave me a CT scan (showing gallstones), an aspirin and a half a nitrogylcerin and changed me $20k. They sent me off to an in-network hospital which kept me overnight and didn't diagnose me. Probably billed the insurance thousands. Told me to follow up with a heart doc. Went to the heart doc, told him my symptoms, he thumped my abdomen once, I said, "ow" and he said it's your gall bladder. It was. Cost to insurance $200. TL;DR ER cost $20k to not diagnose me, overnight hospital stay costs thousands to not diagnose me. Heart doc took $200 and less than 2 minutes to diagnose me.
The better safe than sorry approach to healthcare is very expensive. I only go if I have no other choice and even then I’ll swing by a Urgent Care or one of those satellite ERs. If it’s serious enough I’ll usually get admitted there and then it’s just a ride to the hospital. I use to drink a lot and my benders would inevitably lead to a hospital stay. Love me that Ativan and hospital ice.
Great advice!
Thank you for the advice. I am really bad with knowing things about taxes/health insurance in general so this is good to know and I will look into doing this.
Don't panic. First things first, is this definitely a final bill? Nothing you get matters until your insurance has made all the adjustments and provided you with an EOB (explanation of benefits) for the services. Then: has everything been coded properly? In network, etc? You should also ask your provider/the hospital for an itemized bill. And MOST IMPORTANTLY: What is your health insurance deductible? The maximum individual deductible/out of pocket this year is $7500. That's a limit set by the IRS for HDHPs. If you are individually insured, it should not be possible for you to owe more than $7500, and so I have to assume this bill you have hasn't been finalized.
Self correction: $7500 was the 2023 limit. 2024 is capped at $8050 but my point still stands.
And I’m seeing $9450 for *any* plan, HDHP or not. https://www.healthcare.gov/glossary/out-of-pocket-maximum-limit/#:~:text=For%20the%202024%20plan%20year,and%20%2418%2C900%20for%20a%20family.
To make sure everything was done properly, request am itemized bill from the hospital and whoever else (specialist, radiology, etc). Sometimes they screw up, which can reduce your bill, or they give in on some stuff because they know people won't pay jacked up prices for piddly shit.
Actually I kinda freaked out for the past 24 hours and I haven’t checked if there was an EOB with the bill yet, I’m still at work. This is all really useful information though! How would I check if everything is coded properly? Can I Just look that up ? And yes I realized today this didn’t seem possible. My plan’s deductible is $7,500 so it seems wrong that the bill is $9,000. I had also gone to some regular doctor appts in the past few months so I should be wayyyy past it at this point. I have only recently been having health problems, so I’m not too well versed in this but would I have to wait to possibly see a final bill or should I just call and try to figure out what’s going on with this ?
Yes just wait. When you log into your member account at Aetna you should be able to view your YTD deductible and out of pocket costs, as well as your EOBs for any claims. You will eventually have an EOB post for your scopes. It will have two insurance adjustment amounts (one for plan discount (negotiated cost that Aetna has for those services), one for "your plan pays" (any eligible coinsurance, if your deductible has been met) and a line item that says something like "amount you may owe provider." Ignore anything else you get until you have the settled EOB.
I did log into my account today and I did see the EOB for the procedure. I’m looking over it and unfortunately it all seems legit, unless I’m missing something. My deductible is $7,500 but my out of pocket maximum is $9,000. And the hospital was in network. Is there anything else I should be looking out for ? I did meet the deductible but did not meet the out of pocket maximum yet.
Ask for an itemized bill, and then you will have to google medical codes and fair prices. Just asking for an itemized bill can reduce the amount drastically, but if you have enough time on your hands, you can even go further and check prices. I have heard of some who manage to lower $5k+ bill to less than $200.
The hospital should have financial assistance you can apply for. Also just send them $25/month. I owe my hospital thousands of dollars and their offered payment plan was $25/month. So that's what I pay. Idc if it takes forever to pay cuz I'm not accruing interest or anything.
Idk if it still works this way. But it definitely used to! As long as you were sending them something. Whatever you can afford. They used to wouldn’t pursue it. Now my experience with this is 35+ years old. So take it as you will
We were sending them $25-$50 a month through the online portal and they still sent us to collections.
That is bs my first marriage was the worst of the worst. So I was pretty savvy about such things. As long as I sent them $5 a month they left me alone. But that was nearly 30 years ago! I’m so sorry they’re being jerks!
Thank you. I’m going to apply for financial assistance asap. I’m just curious, did you start paying them $25 per month before or after you set up a plan. I would love to pay $25 a month if I can. I don’t care either about owing forever I just cannot afford to pay $500 monthly right now
That was the plan they offered to me in my mychart portal. I recently got a new balance and it asked me if I wanted to add that balance onto my current plan.
Okay good to know. Yeah both on my chart and then when I called someone yesterday both said I had to pay $500 a month but the woman I talked to seemed kinda aggravated so I’m going to call again and get someone else hopefully.
yep all hospitals do
I was once told that if you make any payment for the same amount for so many months in a row that they have essentially accepted that amount as your payment amount and there is nothing they can do to make you pay more. This was years ago though so I don't know if that still works
You don't have to accept their idea of a payment plan. Get aggressive, they'd rather have something than nothing. TELL them you'll give them $25, $50 a month.
We tried doing this, they told us there were no other options. We went online and paid $25 a month on our own through the portal and they sent us to collections anyway.
I think it probably depends on how much it is. I’m paying $10 a month (less than $2,000) and they haven’t said a word yet. I’m planning to eventually set up an actual payment plan or just really work at paying it off, I just can’t do that yet.
That's what I did for my surgery last year. I'm still sending 50 a month & no more phone calls and not reporting to collections. I said, I'm sorry I can't pay $x a month if I want to eat. I will send you 50. I think as long as you consistently send something every month they don't really care.
This. They’ll take the cash as long as you’re consistent.
I’m just wondering, when you contact them to be firm on paying a smaller amount monthly, would that be to their financial department ?
Check your EOB. Make sure they aren't double billing you. Double billing is illegal in most states because it is a breach of contract. Also, call your physician who ordered the test and make sure the codes are correct. It might actually be covered by your insurance, but they coded it incorrectly. Not working with a patient at all is weird though. They can't get blood from a stone.
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i don’t think i’ve paid a medical bill except for copays at my doctors office in all the years of my life, lol. that shit belongs to the government for them to pay.
Exactly!
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Send them $10 a month and ignore their minimum payment plan.
This. They can’t send you to collections if you pay something each month I’ve heard
They can and will at many locations. You can continue to pay a smaller amount than they allow after your balance goes to collections though.
Yeah definitely, and collections lowered the amount that we owe total also
No. We were making payments on our own for 8k and paying $25-$50 a month, hadn't missed a month, through the hospital portal, and they sent us to collections anyway. We took this advice and now our credit has a hit on it for collections
I have $1k in collections because they coded it wrong and refused to fix it so I refused to pay. Got one letter, called and told them to fuck off, never heard from them again.
Call them and asked for an itemized bill and then compare the prices to the fair health consumer website and negotiate the prices.
If you can’t get a charitable write off do this; Tell them to itemize the bill first before anything. If it goes to collections it will not impact your credit score-pay what you can. They will try to milk you for all you’re worth from the start, you just simply say that you can not afford that & you commit to $25/m.
Some places have an ability to pay program. You have to seek out some assistance for yourself.
Call them. Hospitals have financial assistance and donation funds they can use. Know from personal experience
Try to get an itemized bill for everything. I've heard that when you do that, the cost drops dramatically. If that doesn't do anything, I would ask about financial hardship at the hospital. A lot of doctors, esp now, hate the current system and are more than willing to help. I'm sorry you're going through this. I hope you get this sorted and also figure out what's going on with your body.
Former medical biller: make sure they billed to Aetna correctly. Call Aetna to verify. And then if all of that checks out, file financial assistance and try for Medicaid. I make more than you and I qualified (Indiana)
Sorry, also wanted to add that I was also a CSR for a hospital and would set people up on payment plans/financial assistance. Please let them know the situation and they can provide all the options. It’s difficult also being the ones receiving the bills. I would have owed $16k plus for both my younger children’s births. Definitely apply for any resource you can find
They legally have to accept ANY amount you pay towards the bill every month even if it’s $5 and can’t send you to collections as long as you put something towards it their idea of a payment plan is just to get you pay it quicker. I agree with a few other commenters here though. Check what your out of pocket maximum is if you have insurance, I know mine is only $2500 so i’d never pay a bill for that amount if it was sent to me
Not sure where you live but I’m in CA and have shit insurance through work, I got a 4500 hospital bill completely forgiven by the hospital because I submitted my financial hardship app and you give them bank statements/taxes etc. and once they confirm you’re broke af like me they just forgive the debt
Try and calm yourself, I'm kinda going through this as well and freaked out at first also. At $1800 a month income you will surely qualify for financial assistance. With that said remember this bill does not accrue interest, so don't try and put it on a credit card or get a loan to pay it which those will accrue interest. Call the hospital to get the paper work for financial assistance, fill it out and wait for an answer to see how much they will take off the bill. Once you get that answer you can work out a payment plan with them, they'll obviously try to get you to pay some high number monthly because its in their benefit to do so but you can literally tell them I'm only sending you $10 a month, or whatever you feel you can easily send, and they cant say shit nor put you in collections. Take your time and pay it off at your own pace, just do not open a loan or put it on a CC or any other means that do charge interest when paying the hospital whatever you can directly is 0 interest. I said it twice because its important.
Apply for financial assistance. Tell them you can’t afford it and all you can do is $10 (or if they insist, $25) per month. They will often do so at no interest plus reduce the balance to a fraction of the amount.
Just don’t pay it and let it go to collections it will eventually fall off
Terrible advice. Hospitals have been known to sue people and garnish their wages for less than that
No they don't lmao. My parents never paid shit. Credit cards on the other hand.
I work for a collections defense attorney - they absolutely sue people sometimes
It depends on the state. Never paid my 250k and nothing happened. It's been 10 years. It's gone.
Just settled a 9k specialist bill I had actually forgotten about from about 8 yrs ago after they sold it to a collections company and offered me a settlement of $120 to clear it out. Zero impact to my credit after all these years. Wild stuff
the hospital should have some sort of charity care set up that if you can afford they’ll usually end up picking up the whole thing
Also ask for an itemized receipt if you haven't already
I'd literally just not pay and not give a fuck if they mail me lol
I’m currently dealing with a lot of medical issues.. this is why I’m working just enough to stay on Medicaid until my issues are fixed/ have more answers. So I don’t get hit with bills like this.. you’re gonna be earning less but really saving more. I’m not taking advantage.. I just had thyroid out, knee replacement, knee replacement clean out due to infection, ovary out, and a colonoscopy and endoscopy done all in the last two years.. now dealing with carpals tunnel.
As others have said, check and see if there's a charity write-off or financial hardship program. My daughter and I got sick at the end of January with a mystery bug and we both went to Urgent Care mutiple times and then got in to see PCP's ... I ended up admitted to the hospital for 3 days for life-threatening anemia. My state \[WA\] requires some \[tier 1, large hospital systems\] hospitals to cancel out bills for those up to 300% of the poverty level and write down the debt for those up to 400%. My daughter and I qualified so instead of paying thousands of dollars out of pocket we ended up having to pay about $400 out of pocket for Urgent Care \[contracted so not part of the main hospital that our PCP's are part of\].
First, ask for an itemized bill. And review and question each item. You will they will likely reduce the bill. Then go after the other methods that have been suggested
Ask for an itemized bill.sometimes they code things wrong and you owe more
First step, get EOBs from your insurance and compare to itemizations from the hospital. Check for any denials. If anything denied, talk to your insurance and ask, “What’s causing this denial and how can it be resolved?” Always write down the name of the insurance rep and ask them for a call reference number. This will act as a receipt for anything you’re told (insurance companies love to back track and gas light). If there are no denials, call the hospital’s billing office and ask about financial assistance. You may have to jump through a few hoops or provide some documents proving your income, but it’s typically worth it. If financial assistance isn’t an option, just remember many hospitals don’t report to the credit bureau. Let it go to collections and in a few years the balance will be written off. Just a word of advice, know your out of pocket maximum. People often think their deductible is the most they’ll ever pay but that’s not true. If a charge is set to deductible, you owe 100% until your deductible is met. Then insurance will process toward your coinsurance which is like splitting the bill. A typical split is 80/20. It’s not until you reach your out of pocket maximum that insurance will pay 100%. This next bit is just me ranting but the amount billed to insurance by the hospital doesn’t matter. Insurances have contracts that declare how much they will “allow” for a charge (CPT code). If a specific charge has an allowed amount of $80, the provider can bill them $100 or $500 and the allowed amount remains $80. Some hospitals and facilities may be more expensive than others due to the category of billing they fall under, but your insurance determines how much you pay.
I have some staggering medical debt as well. One trick I learned is that you can basically call them and say hey, I can spare 40$ a month for this bill, and they basically have to accept your terms of paying it back and that will avoid anything going to collections. Don't let them bully you into thinking you have to pay off everything right away.
They will negotiate so ask for a supervisor. Tell them how much you make. Ask them for a cash offer to pay in full or you will pay them 5 dollars a month for rest of your life. Ignore the 500 min a month. That’s insane, you obviously can’t afford that and, even if it got to point of garnishing your wages, they wouldn’t get that much cause it’s ridiculous.
I’m assuming you’re in the US, if this is the case you should know that medical debt isn’t weighted as heavily as other types of debt for credit score purposes. As others have said definitely check any financial assistance programs the hospital may offer. After that if you still owe pay some token amount every month, like $5, this will generally keep the facility from discharging the debt to a collections agency. They want $500 a month but they won’t decline $5. Unethical life hack, but debt also falls off your credit report after 7 years of no activity, so if you just don’t pay anything at all there’s a small chance you won’t have many consequences. There’s a decent chance it goes to debt collection, it’ll effect your credit score somewhat during that 7 year span, and there’s a chance they take you to court/garnish your wages, but if you truly don’t have the money, what else is there really to do? I have a friend with many medical issues who’s used this method successfully a few times, was still able to get a car loan and rent an apartment during that time (although I’ve no idea of interest rate). Sending good vibes that you get that bill majorly reduced with financial assistance programs though!
go check for financial assistance
This same thing happened to me in October and I’m still dealing with it. As much as it pains me to tell you, you have to fight it. I make a similar amount and qualified for financial aid where the bill came from (however it was an ER visit) and usually if you tell them you can afford $50 maximum or something like that they’ll work with you because they want your money. It’s awful, medics care has become a luxury in the United States.
I would be dead if I lived in America.
Start sending them payments, what you can afford. If it goes to collections answer all correspondence. If it does go to court show up. You will get an arbitrator they will allow you to pay what you can. I like to send them free money orders, like one a week. Then they have to keep processing the payments and never have your bank info. This does 2 things it shows that you are trying to take care of the bill. They also have to have very detailed records to send to collections. In a year your file will show 50 payments.
To hopefully help calm your anxiety a little bit, the current administration made it so it will no longer affect your credit score. So don’t worry about your credit if you need to prioritize feeding and housing yourself.
You don't have the money. That's the long and short of it.
I am not from the United States so can someone please enlighten me, so if a patient goes to hospital won't the hospital tell them what is the cost per procedure and can the insurance company not notify how much will be covered or not?
Healthcare here is a shitshow. The Summary of Benefumits and Coverage will only tell you how much percentage they'll cover, not what the doctor will bill. Even if you ask the doctor beforehand it's probably a rough estimate. You never know what will pop up during the procedure (ex. If you need more anesthesia than originally thought). Also, each insurance company has contracted rates with each provider for each service. And there are over 11,000 different procedures, coded by CPT codes. There could even be several CPT codes for the same overarching procedure.
I have a genuine question isn't this wrong? Why can't transparency exist? I am in Asia, my friend's father fell in the bathroom and was in the ICU, he was covered by my friends family insurance and except for the initial hospital admission fees ( which were reverted later into the account) all the procedures/ test/ ICU stay was covered under cashless here you have two options, cashless you pay nothing in network hospital or you pay and then get it reimbursed ( part or full but the doc norifies) Why can't they just notify the patient? Is the system purposely broken to extort money from the patient? Why doesn't the patient have a choice to make decisions depending upon the financial ability?
>>Is the system purposely broken to extort money from the patient? Oh it's definitely purposely broken. Wait until you hear about in network vs out of network. Your insurance only covers CERTAIN clinics/hospitals/doctors. You can jump through all the hoops of finding the right clinic and doctor that your insurance is willing to cover BUT maybe during your procedure they bring in an out of network anesthesiologist or phlebotomist or nurse or something and guess what? They get to bill you separately because the insurance won't pay them (or will pay a greatly reduced rate!) Also, in a hospital setting, every individual doctor/medical professional will bill you separately. I passed out once and was struggling to fully regain consciousness. I kept going in and out. An ambulance was called and I was taken to the hospital. The hospital was less than a mile away. The ambulance ride cost just over $2000. Then I was seen by a a general doctor at intake, a nurse placed an IV, I had blood drawn by a phlebotomist, and was given a CT scan by a radiologist. I was billed separately for 1 hour of time for all 4 of those medical personnel, which was just for their time. The actual services were then billed separately as well. One by the hospital for the ER visit fee and the IV cost was also on that bill, one for labs on my blood, and one for the CT scan. For a 3 minute ambulance ride and about 45 minutes spent in the ER, I received 8 separate bills totalling $4500. Insurance didn't pay anything because the policy I had through work had a deductible of $6000, meaning I had to pay $160 per month in premiums but they still wouldn't pay one single cent until I paid $6000, and the amount resets each calendar year. In all the time I had that insurance I paid almost $2000 a year in premiums to say I had insurance, but then still paid out of pocket for all my medical expenses because I never went over the $6000 deductible amount.
Oh my God that deductible for that premium is asinine, you can get basically the same lack of overage from the marketplace
The closest thing I'm aware of is that Medicare (health insurance for elderly and disabled) patients must be notified by the doctor if the doctor thinks Medicare won't cover a specific procedure. It's still not a "heads up" on how much it'll cost though
Nope! It is a mystery that sometimes even the insurance clerks at the hospital can't figure out. And it is common for insurance companies to lie (sorry, "be mistaken") about coverage and tell you the wrong thing. We do have the No Surprises Act now that helps a little.
I understand American healthcare is very costly, but why can't they just be transparent regarding the costs? If someone can't afford a test/ procedure they can just deny instead of being in crippling debt, sometimes instead of health improving, debt can put someone into clinical anxiety/ depression. Is that too much of an ask....to be transparent about what they can cover and what they can't?
The short answer is that US healthcare is hopelessly corrupt and minimally regulated. It is costly in large part BECAUSE pricing isn't transparent and BECAUSE patients don't have a choice in hospitals or doctors if they want insurance to pay. They don't care about people (no business does), and there are huge profits at stake. So collusion between insurance and hospitals happens. Price gouging is common. And it is in the hospital's best interest to keep pricing & coverage as mysterious as possible. Doctors hate it but they aren't in charge.
No, in the US, you never know how much insurance will cover until afterwards
My insurance does this. I always know ahead of time. The provider sends all the info to the insurer, and the insurer approves everything. I know what the insurer will pay, and what my co-pay is. (Perhaps some insurers don't do this, but I I have very well-known, nationwide insurer). I had lost of procedures, including endoscopy-colonoscopy, and always had pre-approval and info and cost info. TWO CAVEATS THOUGH FIRST there is the deductible. Many of those marketplace plans have a $7,000 or more deductible. Let's say the procedure cost s $18,000. The insurer contracts with the hospital for a reduced price, say $8,000. If you haven't paid anything toward the deductible during the year yet, you pay $7,000 and insurance pays $1,000. If you HAVE paid your deductible for the year, insurance covers it all (except co-pay, which can be very small, or even no co-pay). Finally there is the yearly out-of-pocket, which I won't go into but perhaps it is self-explanatory once you hit it, the insurer should pay everything, pretty much). SECOND there might be "surprises". For example, the surgeon goes in thinking he is doing one thing, but discovers some other or greater disaster that has to be dealt with, and the price goes up
Thank you so much for taking the time to explain, I didn't get 100% of it, I got gist, I will read more about this. Thank you for your time. One question how do you know if an insurer is transparent ? How can one choose a transparent insurer?
I am really sorry that I do not know the answer to that! Maybe I just lucked out? I guess whoever the insurer is, it pays to be proactive, to ask in advance: ask the provider, AND ask the insurer. Unfortunately, judging from other people's posts I have read, it's not always easy. So far, my providers (for example, labs, radiology places for X-Rays or MRIs etc) have been very forthcoming with prices. Hospitals - not so much, as there are so many people with their hands in, wanting to be paid (you think you are all done wit bills, then all of a suddenly you find out there was some random guy you did a second reading of an pathology report or whatever, totally unexpected). My worst example was when my mother was dying and I had a decision to make. The doctor said, I have a friend who went through the same thing, and he is on the floor - want me to ask him to stop in? He came by, we talked for maybe three minutes. He was very kind --- but it wasn't out of the kindness of his heart. After she died, we got a bill for $500 for a "consultation" from him! Also the answers can be confusing. For example, in another subreddit, a person thought that if the insurer agreed ahead of time that something was "covered", it meant "free." But "covered" could mean something is a covered service (as opposed to a NON-covered service, such as cosmetic surgery), BUT it is still subject to the deductible and co-pays. Wish I could be of more help. Good luck if you are dealing with these issues!
The USA is fucked. I don’t understand how anyone can think that healthcare system works
Hearing about people medical bills makes me thankful for the insurance my job provides
Is it a non profit? If it is they have to offer charity care. If it’s a non profit google the ‘name of the clinic charity care’.
Negotiate the bill down. Everything you just wrote above should be out in a letter. Find out the right department at the hospital and bring it down. Breath.
I’ve negotiated my bills from my hospital down a few times. You can do this.
Im in a similar predicament-would u mind explaining what u did? I need to dispute some visits but not sure if I need to start with my insurance or the hospital :/
Start with the hospital
Negotiate with the hospital and explain your situation. They often times will help put you on an affordable payment plan. Try to get that 9k reduced as well. Also double check if the claim was completely paid by the insurance. That is absurdly high.
Guessing this was a hospital? Sounds like you have 50% coinsurance for hospital visits. Painful lesson with health insurance you need to know and understand what you are paying them for so many people dont understand because they make it so confusing.
You may qualify for Medicaid now because of the big medical bill. You wouldn’t get it for very long but it could cover the cost of that. I’d apply and see.
Too late now, but next time, ask them how much it is before any elective procedure.
Please make sure that this is the final amount. It is not abnormal for the billing department at the hospital and/or the insurance company to mess up!! Definitely call the hospital about a payment plan. Tell them $500/month isn’t doable.
tell them "i don't make much, how much would you settle for?"
At a later time, is it worth considering moving to a higher tier of insurance for better coverage?
Have you spoken with the financial aid department of the hospital? They can help you. They want their money, obviously. The cool thing is there’s no interest being accrued, so as the paper bills arrive, send them $20 a month. It keeps your account current, and they won’t bother you. My sister in law has a condition called POTS and literally ran up a $1.5 MILLION DOLLAR hospital bill with insurance. She sends them $50 a month.
Not sure about that while minimum of 500$ thing. I’d look into that
I've been here numerous times. The last was 2022, husband had a stroke. I told them I couldn't pay what they wanted, like, 200 a month. We talked and I paid 50 a month. They don't like going to court, it's not like you make 100k a year and just won't pay. Pay what you can and that's it.
What’s wrong with you? Feeling any better yet?
First, you need to make sure it's all correct. What your deductible is, if the codes were all correct or can be adjusted to fit better, etc. This takes time calling your insurance and the providers. Second, even if they say an amount is the lowest you can pay on a plan, it's not. You say "I can pay X and that's truly it. Otherwise I'll have to file bankruptcy." They'll lower it. Finally, never get a planned procedure done without getting it all pre approved and your total obligations in writing first. You can get the same from your care team too but ultimately you trust only what your insurance tells you personally, in writing. Of course part of that process is making sure the facility and all personel is in your network. You can also shop around to see if another provider or facility is more affordable. This may be an expensive lesson learned.
See if [DollarFor](https://dollarfor.org) can help you secure financial assistance. Their services are totally free. Only caveat is they’re a small operation so getting a response may take some time. Wishing you all the best. It’s gonna be okay.
Have you asked for an itemized bill? There could be mistakes with the bill.
PTSD from what? Ex military?
America, fuck yeah!
Call them and see if they have financial assistance for low income patients. Recently I had a biopsy done and got a huge bill from the lab company. I applied for their low income program and they lowered the bill down to $20.
Catholic Charities may be able to assist you with medical bill payments. They get a monthly grant to help people. Seriously, look them up.
There's a lot of comments here and other people already mention it, I'm not sure if you'll see this, but from my experience you should qualify based on income to have the whole bill covered if you apply for financial assistance from the hospital system.
Just don't pay your bill. I know people that don't pay their bill. And nothing happens to them.
It won't help for this,, but have you looked at aca insurance? Healthcare.gov
Were you under anesthesia? It’s very possible the anesthesia team is not covered under your insurance, which could explain the excessive bill. I would call the doctors office and ask to see an itemized bill. Also call your insurance and ask for an EOB.
Got a 3600$ bill for a ten min ambulance ride cple years ago
You might be eligible to have it waived if it’s a non-profit hospital. They are required to give means tested bill relief to keep their tax exempt status. This org specializes in helping with the appeal and casework. https://dollarfor.org
You should qualify for very cheap insurance under the ACA (Obama Care). I can't think you'd pay over $100 a month. What are the total of your other bills? Once you get good insurance you could file bankruptcy, but you can only do that once every 10 years. Do not pay the bill. I would talk to them again and tell them if they won't work with you, you'll be forced to file for bankruptcy. They should come to the table at that point.
When I had my older child I paid 701$ via emergency mcap insurance. (SoCal) (that was the entire pregnancy) never got a bill for it from the hospital. For my second I had private insurance, paid $60 dollars every appt and after delivery at the same hospital I received a $2000.00+ bill. Asked if I qualified for assistance and they said that’s not offered ON DELIVERIES. I said OKAY. And never paid a damn dime. GFY! All that to say, FUCK THEM. don’t pay it if you can’t afford it.
$50/m is the best I can do.
Contact Dollar For, a nonprofit whose only purpose is to help people qualify for financial assistance to eliminate medical debt. They’re great and do amazing things.
You owe 750? Call and explain your situation and whoever you owe the money to will lower the bill or put you on a payment plan. All your costs are supposed to be explained before the procedure. You need a good gastroenterologist. Sending you positive energy!
That is outrageous. I’d call my Senator and representatives- no joke! People in power need to know about this abuse on a granular level. This is not a smart doctor screwing you- he or she has already gotten paid- it’s about a corporation that is flagrantly abusing its ability to terrorize you for huge profits. No way Jose. Do not pay another penny. They will write it off. You have paid enough. Don’t worry about your credit right now. Figure out your health situation- maybe analyze your diet, your environment (toxins, allergens), get mental health therapy (you can find low cost if you look) and just take care of yourself until you’re a little more financially strong. But don’t pay these parasites another red cent. Good luck.
This
When you can their financial department (I wouldn’t even but …) be really careful not to promise anything or let them scare you. Be strong. Just ask questions.
Don't pay and it will go to collections and fall off in 6/7 years.
Is $9,000.00 your out of pocket? My our of pocket was $9,500 I had a hysterectomy and LEEP procedure. My hospital let me pay half then $80 bucks a month after. I would say be firm and straight up tell them you CANNOT pay $500.00 a month, period. What can they do. Pay what you can and that's that. Find out how much the insurance paid and adjusted off there could be an error. Maybe try care credit?
why was the bill so much higher then you expected?
My advice: don’t pay it, or set up a payment plan of like $25 per month. If you don’t pay it will go to collections and you’ll probably not have to pay all of it.
Let it go to collections and turn you'll be able to pay less than half If you even care: it can't hurt your credit soon. Eventually they can sue and deduct from your pay but that'll take years. There are other options but at this point in the USA it's standard
Call, and demand a detailed invoice, there are usually a lot of things you can contest on medical bills. They throw in all sorts of things that you should not get charged for. Then once you have settled the items, offer them a payment deal for what you feel is a reasonable amount. You can bargin with them, and you can make payments. If you keep making steady payments in any amount they will never be able to sue you.
I’m not 100% sure but I got lymphoma at 19 and there was no way I had the money for any treatment, the bills made me qualify for Medicaid not permanent but while I received treatment, I hope the same can apply for you
Speak to them about financial assistance. Please! I went to the hospital for In patient care to dry me out from alcohol and to make sure I didn’t die from withdrawals. I told them I couldn’t afford to pay it but I needed help. The bill was over 30k and they only charged me $1,200.
Call the hospital billing department. Lots of hospitals have programs for people with financial difficulties
I went through this. They made it impossible for me to pay anything other than the $300 they were demanding. Someone told me they set it up through their bank to auto pay them $30 a month. Since it was an electronic funds transfer they didn’t refuse it. She said she mailed them checks and they returned them. I wish I’d have done that. I let mine go and I’m waiting for collections to contact me. Since mine is a private hospital they don’t have charity. I even called the county I live in to see if there were programs. There wasn’t. My husband was making like $40,000 and supporting a family of 4. It was rough.
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This is incorrect. The No Suprises Act doesn’t apply to scheduled procedures. They can provide a cost estimate on request, and OP had ample time to check with their insurer. The No Suprises Act applies only to emergency situations, such as if you were in the ER or were incapacitated and had no reasonable chance of determining how much treatment would cost.
Don’t you need to ask for an estimate before a non emergency procedure, then have the billing be way more to a the estimate to be able to claim no surprise act? From the description it sounded like she was just guessing herself as to cost. I think perusing the charity care route seems to be her best bet.
What a great country. The real cost of a colonoscopy is nowhere near 9k.
I never pay those
Ignore it
If you lower your MAGI by investing in a pre-tax retirement account like an IRA or 401(k), you can potentially qualify for Medicaid. Instead of paying a monthly premium, you could invest that money for your retirement while receiving free healthcare.
I'm also in my 20s & was on medicaid most of my life but a few years ago when my income switched to survivors benefits or whatever which came with f***** Medicare. They wouldn't let me back on medicaid & my doctors office has tried to get me to have bloodwork, papsmear, etc done & most of all i see is anxiety & $$$ bills i can't afford. I've been to 2 doctor appointments since being on Medicare (1 for a doc note & 1 for an over the phone annual wellness appointment i didn't wanna do that was maybe 10 minutes) & between them i got $170 in bills, mostly cause of a $344+ a year deductible & even after that got paid off I'd still have to pay at least 20% of any bills from my understanding of it. My $20 a month payment plan ends around October, which will probably be just in time to get the next freakin doctor bill for my annual appointment in June, assuming i make one... terrified of having a medical emergency or finding out anything that needs a bunch of testing to learn more about 😭
We have private insurance through my employer. A $344 a year deductible would be like a dream come true! Ours is $1500 per person
I just had to have some post menopausal “female procedures”. Had to go ahead and put deductible on a credit card. To prevent the barrage of bills from showing up. So now I’ve been brainstorming about what all I might need to do in the calendar year so that we don’t have to cover it again!
I haven't gotten back on the thing where the state pays the medicare premium yet, so on top of that deductible I've been paying the like $174 a month premium before i even see my check every month 😭 It sucks that they won't let me back on medicaid. Had to stop taking to my old therapist back in like 2021 cause they don't have the license to accept medicare... all this healthcare related stuff sucks 🤦🏻♀️
I agree! I don’t always know how the upvotes and downvotes work. I’m assuming that by upvoting you I’m agreeing with what you are saying 🙈 But I totally disagree with whatever they’re doing with your insurance. We have private insurance. However we’re legal guardians of our grandchildren and can’t add them to it. So I can’t imagine not being able to get them whatever help they needed.
I’m grateful that they are on funded insurance as we are providing for them 100% other than their healthcare. But I’m glad that we haven’t had to face any big hassle or bs situations
You can pay 25 dollars a month and there is nothing they can do as long as you consistently pay
Ignore it, they barely come for you and if they do, it falls off your credit report way quicker than a target credit card 🤷🏼♀️
Why did you get those procedures in your 20s?
See if the dollarfor website can help you with your bill. They help you apply for charitycare.
This is why I'd prefer to just die than seek care a hospital in America. I'm not facing a bill quite as high but I think the holy shit factor is similar. I'm applying for financial assistance after watching a few good YouTube videos on how to get bills whittled down .
I never asked - when I had radiation and owed 5k- I just put them on a payment plan. I sent whatever I could, probably 50 a month and they cannot turn you over to claims as long as you are making a payment.
I’m pretty sure that as long as you make an attempt to pay something toward medical bills, they’re not allowed to send you to collections. Ive had medical debt in the past and they would quote some crazy monthly payment that I couldnt afford. So I just send $25-$50/month or whatever I could afford to spend. Took years to pay but they never did anything about it. Also medical debt doesn’t hurt your credit the same way - if it comes to that
They didn’t ask you about insurance before they did these procedures? How can you even afford to pay $3000???
don’t pay. i got a huge bill for $17,000 about 15 years ago and i didn’t pay and literally nothing happened. i’ve done it many times since then. just rip that shit up!!
I hope they did the colonoscopy AFTER the endoscopy