Medical bills, which can range from hundreds to thousands of dollars, are stressful and frightening. When debt stems from circumstances beyond your control, the emotional toll can be even greater.
My family and I know this all too well. After a high-risk pregnancy and a child who needed their first of many surgeries at just one month old, we faced mounting medical debt.
Over the following years, hospital admissions, therapies, and surgeries added up — along with thousands of dollars in bills. For me, the strongest emotion was shame. Even though we had done nothing wrong, the sheer weight of debt was overwhelming, and I felt unable to discuss it with anyone.
Looking back, I understand a simple truth: medical expenses happen. Even when you do everything “right,” illness, accidents, and unexpected costs even with insurance can quickly add up.
If you are struggling with medical debt, know this: you are not alone.
A 2019 review of the 2015–2017 National Health Interview Survey found that 137.1 million adults experienced financial hardship due to medical expenses in the past year. Of these, nearly 47% of adults ages 18–64 reported psychological distress, and more than 28% of adults 65 and older reported similar challenges.
Illness, injury, and healthcare costs are part of life. For millions of Americans, that means medical debt. But there are steps you can take to face these expenses, reduce what you owe, and prevent bills from being sent to collections. While this isn’t financial or legal advice, here’s what I wish I had known — practical ways to manage medical bills and find help.
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What to Do If You Can’t Afford Your Medical Bills
If medical bills are piling up and you can’t pay, there are practical steps you can take. Here are seven strategies to help manage your medical debt.
Don’t Ignore Your Bills
The first step is to gather all medical bills and any related insurance correspondence. Organize them by service date and provider if possible having everything in order will make it easier to address issues.
It can be tempting to ignore bills, toss them in a drawer, or “deal with them later,” especially when they feel overwhelming. But avoiding them can make the situation worse.
Stay proactive. Contact your hospital, doctor’s office, or other service provider to discuss your bill. Research from Yale University found that over 75% of people who reached out about a medical bill they couldn’t pay were able to negotiate a lower cost.
You may have an opportunity to reduce your bill or find out if your provider offers financial assistance. Keep in mind that there is often a time limit to challenge a bill or request help, so acting quickly is important.
Carefully Review Your Medical Bills and Insurance Documents
Mistakes on medical bills are more common than you might think. A Yale University survey found that 1 in 5 people discovered errors on their medical bills. Reviewing your bills carefully can help you catch mistakes and potentially save money.
If you haven’t received one, request an itemized statement for all services billed to you. Remember, a single medical encounter—like surgery—may generate multiple bills: one for your surgeon, one for the hospital or clinic, and others for healthcare professionals such as anesthesiologists.
The Centers for Medicare & Medicaid Services (CMS) recommends these steps (useful for anyone, not just Medicare recipients):
- Get a detailed, itemized bill.
- Compare with your medical records. Make sure every charge matches the services you received.
- Check your insurance coverage. Request an Explanation of Benefits (EOB) to see what your insurer paid and what you still owe.
- Watch for duplicate charges. Ensure you’re not billed twice for the same service.
- Verify medical codes. Compare the codes on your bill to your services:
- ICD codes: Record medical diagnoses
- CPT codes: Record procedures and services
- HCPCS codes: Cover procedures and services not included in CPT codes
- Seek professional help if needed. Contact your state’s patient advocate program or a consumer assistance program for guidance.
Once you’ve identified any discrepancies, contact your healthcare provider’s billing office or the hospital to clarify confusing charges. If you find errors, dispute them promptly with your provider or insurance company. Keep in mind there may be time limits for challenging charges or insurance payments.
Always document everything. Keep records of all calls, written correspondence, and copies of disputed bills. Promptly notifying providers and your insurance company is key to resolving errors and avoiding unnecessary payments.
xplore Financial Assistance Programs at the Hospital
Many hospitals offer programs to support patients facing financial challenges. Often called “charity care” or “charity assistance,” these programs may reduce your medical bills if you meet income requirements.
Nonprofit hospitals are required to provide financial assistance to maintain their tax-exempt status, so it’s worth contacting the hospital’s business office to see if you qualify.
You can also speak with the hospital patient advocate, usually located in the billing department. If you’re admitted for a hospital stay, you may have access to a social worker who can help you navigate resources and find assistance for paying your hospital bills.
Know Your Rights
In the U.S., there are laws that protect healthcare consumers. Start by checking your state’s Consumer Assistance Program website for specific protections. Key federal rights include:
- No Surprises Act: If you have private insurance, you should pay no more than the in-network rate when treated by out-of-network providers without your consent. This law does not apply to emergency care. If it’s violated, you can file a complaint with CMS.
- Good Faith Estimate: If you lack private insurance, request a cost estimate at least 3 days before care. If the final bill exceeds the estimate by $400 or more, you have the right to dispute it.
- Fair Credit Reporting Act (Regulation V): This law prevents creditors from accessing your medical information for credit applications and bars medical debts under $500 from being added to your credit report.
Apply for Government Assistance
If you have a chronic condition or need long-term treatment, programs like Medicare, Medicaid, or the Children’s Health Insurance Program (CHIP) may help cover medical expenses.
- Medicare: Available for adults 65 and older (enrollment required).
- Medicaid and CHIP: Eligibility typically depends on income and age. Applications can be submitted online or in person in your state.
While these programs usually don’t cover past medical expenses, they can help with future costs, especially if you have ongoing medical needs.
Seek Help from Nonprofit Organizations
Nonprofits such as the Patient Advocate Foundation and the HealthWell Foundation assist individuals facing medical debt. Their experts can:
- Review medical bills for accuracy
- Dispute incorrect charges
- Negotiate reduced costs
- Connect you with additional resources
Hire Expert Help
If you don’t qualify for assistance, you might consider hiring a professional to review, negotiate, or dispute medical bills. Medical billing advocates are trained to help with these tasks and can sometimes save you money even after paying for their services.
Professional organizations, such as the Alliance of Claims Assistance Professionals (ACAP), can help you find an accredited medical billing advocate in your area. These experts may work independently or through law firms, depending on your needs.
Frequently Asked Questions
What should I do first if I can’t pay my medical bills?
Start by gathering all your medical bills and insurance documents. Stay proactive and contact the billing office to discuss your situation—ignoring bills can make matters worse.
How can I check if my medical bills are accurate?
Request an itemized bill and compare it with your medical records. Verify charges, medical codes (ICD, CPT, HCPCS), and insurance coverage. Dispute any errors with your provider or insurance company.
Can hospitals reduce my medical bills?
Yes. Many hospitals offer financial assistance programs (sometimes called charity care). Eligibility often depends on income and financial need. Contact the hospital’s business office or patient advocate to apply.
Are there government programs that can help?
Yes. Programs like Medicare, Medicaid, and CHIP can assist with medical expenses if you meet eligibility requirements. They usually help with future medical costs, not past bills.
Can nonprofit organizations help with medical debt?
Absolutely. Organizations such as the Patient Advocate Foundation and HealthWell Foundation can review bills, dispute errors, negotiate reduced costs, and connect you with resources.
Should I hire a professional to manage medical bills?
If you don’t qualify for assistance, hiring a medical billing advocate may help. They review bills, negotiate with providers, and can sometimes save you money. Look for accredited advocates through organizations like ACAP.
How can I keep track of disputes and negotiations?
Always document calls, emails, and written correspondence. Keep copies of disputed bills and any agreements to reduce charges or set up payment plans.
Conclusion
Medical bills can be overwhelming, stressful, and sometimes confusing, but you are not powerless. By staying proactive, carefully reviewing your bills, understanding your rights, and seeking available assistance, you can reduce financial stress and avoid unnecessary debt. Whether it’s negotiating directly with your healthcare provider, applying for hospital financial assistance, utilizing government programs, or working with nonprofit organizations and medical billing advocates, there are multiple strategies to manage medical expenses effectively.
