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How to get Assistance with Medical Bills

by Karen Berger, Pharm.D.

Do you dread opening your mailbox to see bill after bill? Between the mortgage (or rent), car payments, groceries, and other essentials, it can be extra stressful when you add on medical debt, too. Bills from medical services can add up. 

If you do struggle with medical debt, however, you’re not alone. A Kaiser Family Foundation and New York Times survey found that more than 1 in 4 Americans had trouble paying a recent medical bill. Medical debt can affect people of any age or economic status. What’s more, almost 1 in 3 Americans reported delaying medical care because of concerns about the cost.

Making sense of medical bills

There are steps you can take on your own to prevent unnecessary debt and to ensure that you’re only paying for services you’ve received.  In the struggle against excessive debt, asking the right questions is your secret weapon! Several years ago, I received a bill for over $3,000 for a routine outpatient ear surgery. I had to call the insurance company many times until I reached someone who figured out that the claim was coded incorrectly. All they had to do was make a simple adjustment and resubmit the claim, and I only owed $250. It pays to ask questions. If you think a medical procedure or service should have been covered, and you receive a bill that’s higher than expected, ask questions. Do not just give up and pay the bill if you think there is an error. It may take a lot of time, effort, and frustration, but it is worth it in the end!

Help lowering your medical debt

Unfortunately, medical costs in the United States are expected to continue rising, but there are ways to identify billing errors, get around redundant costs and lower your medical expenses.

  1. Call 211. 211 is a 24/7 resource that connects millions of people with local help, including health care and insurance assistance. In 2022, 211 responded to more than 1.6M requests for healthcare resources. No other network in the country has a similar pulse on America’s needs.
  2. For a life-threatening emergency, you should always go to the emergency room. By law, anyone with an emergency must be treated or stabilized, regardless of the ability to pay. However, if you don’t think your condition requires emergency care, consider whether an urgent care center would be equipped to handle your symptoms. Or, search the National Association of Free & Charitable Clinics to find affordable medical care in your area.
  3. Carefully review all bills, and ask questions if something doesn’t seem right (see Success story above). Up to 80% of medical bills have errors. You should not have to pay for something that was incorrectly billed. If you need help, consult a medical advocacy group, patient advocate, or social worker through your healthcare center. 
  4. Talk to the billing department to negotiate a lower bill. Sometimes they may waive certain charges. Ask about the best way to pay your bill. A payment plan may be a good option (but check the fine print and interest rate). You can also ask if they offer a considerable discount if you can pay upfront.  
  5. See if you qualify for Medicaid, which is funded by the government. You may qualify if you are a senior citizen, fit income eligibility requirements, or have very high medical expenses. 
  6. Check into grants and financial assistance programs through hospitals or organizations such as the Patient Access Network Foundation, HealthWell Foundation, or Samaritan Health Services
  7. Medical care often includes medications, and luckily there are several ways to save on prescriptions. Asking for a generic version of your medication can save you hundreds of dollars. Not only are they much more likely to be covered by insurance, generic drugs can cost up to 85% less than brand-name drugs, according to the FDA. For example, brand-name Adderall costs nearly $600 for 60, 20 mg tablets, whereas generic Adderall costs $95 for the same prescription. There is a similar difference of about $545 between brand name vs. generic Lipitor prices.

While it may seem daunting, effective management of medical expenses is possible if you know where to look. 211 strategies and support can help anyone, anywhere get access to the healthcare they need to thrive.