What happens when you can't pay your medical bills?

To fight back, your best bet is to be a well-informed consumer

It's no secret that health care costs have been spiraling out of control for years.

To fight back, your best bet is to be a well-informed consumer: Know the true costs of medical procedures, supplies and medications so you can bargain effectively; carefully anticipate and track medical expenses; and stay on top of your bills.

But sometimes, even when you follow the rules you still can get burned. I've heard many appalling stories about people – even those with comprehensive insurance – who have been denied benefits, over-charged, sent to collections or even forced to file for bankruptcy because they couldn't pay their medical bills.

Here are a few coping strategies:

Carefully review each doctor, lab or hospital bill and match it against the Explanation of Benefits statement that shows how much they were reimbursed by the insurance company. Also, watch for items that may have been charged to you by mistake such as:

• Medications, supplies, treatments or meals you didn't receive while hospitalized or getting an outpatient procedure.

• Duplicate charges for a single procedure (such as x-rays, MRIs and lab work), including those that had to be redone due to a technician's error.

• Charges for a full day's hospitalization when you checked out early; or private room rates when you shared a suite.

The summary hospital bill you were sent probably doesn't contain many details, so ask for an itemized bill along with a copy of your medical chart and a pharmacy ledger showing which drugs you were given during your stay.

If you're having difficulty paying a medical bill, don't simply ignore it. Like any creditor, doctors and hospitals often turn unpaid bills over to collection agencies, which will wreak havoc with your credit score. Contact creditors as soon as possible, explain your situation and ask them to set up an installment payment plan or work out a reduced rate.

Many people with no insurance discover that they're often charged much higher rates than those negotiated by insurance companies, Medicare and Medicaid. Don't be afraid to ask for those lower rates and to work out a repayment plan – just be sure to get the agreement in writing. Most doctors and hospitals would rather accept reduced payments than have to deal with collection agencies and possibly no reimbursement at all.

Ask the hospital's patient liaison to review your case and see whether you qualify for financial assistance from the government, a charitable organization or the hospital itself. Most will forgive some or all bills for people whose income falls below certain amounts tied to federal poverty levels. Also pursue this avenue with your doctor or other provider – ideally before they've begun collections.

A few additional cost-savings tips:

• Ask whether your employer offers flexible spending accounts, which let you pay for eligible out-of-pocket health care and/or dependent care expenses on a pre-tax basis.

• Use online price-comparison services like Healthcare Blue Book and to research going rates for a variety of medical services.

• Unless it's a true emergency, try to avoid emergency rooms and use an urgent care network facility affiliated with your insurance company or ask your doctor for recommendations.

Bottom line: Know what health services cost and don't be afraid to negotiate. You'll haggle over the price of a car – why not your health?

--Jason Alderman directs Visa's financial education programs.


Like this comment
Posted by Mike
a resident of Highland Oaks
on Jul 31, 2012 at 5:30 pm

Good advice.

I've enjoyed remarkably good health, knock on wood, so I've never really thought about it: do hospitals and other facilities actually publish price lists?


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Posted by Bill
a resident of Amberwood/Wood Meadows
on Aug 1, 2012 at 10:14 am

My wife became ill during on a visit to France with a tour group a few years ago. She became so incapacitated with a GI ailment that the hotel called a 3 o'clock in the morning. The doctor came within 1/2 hour, ran a diagnosis and gave her medication which gave her relief and started her on the road to recovery. Cost for the doctor visit was $60.

About 10 years ago one of my kids became ill, also with a GI ailment. Because he was unable to keep anything in his system, he started to get dehydrated. I took him to Valley Care Emergency. It was a routine process to rehydrate with saline solution, and add pain and anti-nausea medication. Total bill was over $5000. Of course the insurance only paid a fraction of this cost, but if I did not have insurance I would have been responsible for the entire 5000 dollars.

The cost just to be in the emergency room runs around $1000 an hour. If you are in the emergency room after hours it adds cost. If you are in the emergency room on the weekend it adds cost. a 5 minute consult with a doctor was $300.

Lord knows what the bill would have been if physical trauma was involved.

Not saying the people at Valley Care are not helpful, dedicated, professional employees. Just saying $60 vs $5000 is quite a difference for exactly the same treatment.

So yes, if you do not have insurance, even a non-traumatic visit to the emergency room in any bay area hospital can lead to bankruptcy for an unfortunate soul.

Good luck in getting rates from any hospital. Fair and reasonable is not in a medical CFO's vocabulary.

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Posted by jeffreydan
a resident of Mohr Park
on Aug 1, 2012 at 10:56 am

Thanks for this info. I will now ask for an itemized list for my 4-day in-patient treatment for Pneumonia last year. I received excellent care and treatment but, I think I could have come in each day for an hour or two as an outpatient and been fine. The doctor's insistence that I needed to be admitted to a 4-day stay cost me $30k to $35k. The total hospital-only bill was $56k. My health insurance was suddenly cancelled by Anthem/Blue Cross the previous month. Swell.

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Posted by Arnold
a resident of another community
on Aug 1, 2012 at 11:45 am

Sounds like this site is being overrun by socialists.

Everyone knows that the reason medical costs are so expensive in this country is because of unionized nurses and janitors.

France does things cheaply and responds so quickly because nobody calls them anymore. They can't afford it. The $60 fee for doctors visit AT A HOTEL is just too much money for most Frenchies because the unions have stolen everything from their pockets. I'd much rather pay a $5000.00 medical bill in this country than a $60.00 bill in socialistic France. (When's the last time they won a war?)

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Posted by Bill
a resident of Amberwood/Wood Meadows
on Aug 1, 2012 at 11:52 am

@jeffredan - Sounds like Anthem Blue Cross/Wellpoint. The insurer that people love to hate.

Pretty soon everyone in India will know your medical history. In the not to distant future your medical history will be for sell on the black market. But your spouse will still be prevented from getting medical information.

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Posted by Mr. Mittens
a resident of another community
on Aug 1, 2012 at 12:48 pm

I don't think one's medical information should be anyone else's business. Presidents should be elected on blind faith. Same is true for tax returns. What's the big deal anyway?

Mitt -- Always honest, and if you don't believe him, tough; he doesn't need to show no stinking tax returns.

Like this comment
Posted by Uncle Steve
a resident of Another Pleasanton neighborhood
on Aug 1, 2012 at 6:18 pm

Mr. Mittens,

I'm a lot more concerned that we can't see Obama's REAL birth certificate, his school records, his Indonesian citizen status, and how he got the scholarship to Columbia available only to foreign students; than I am about Romney's tax returns. I'd also like to know more about why Obama's grandparents arranged for a member of the Communist Party to be his role model and mentor when he was a teenager. At least Romney was making money to pay taxes. Obama has been on the public dole for all but about 1 year of his adult life.

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Posted by Uncle Steve
a resident of Another Pleasanton neighborhood
on Aug 1, 2012 at 6:21 pm

If you are among the 50% of the people in the country that don't pay taxes, you will be delighted with ObamaCare. You will get free medical care -- that is until the country goes bankrupt in 3-4 years. If you are a taxpayer, you get hosed -- now, and then again in 3-4 years.

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Posted by Uncle Steve
a resident of Another Pleasanton neighborhood
on Aug 1, 2012 at 6:27 pm


What you didn't hear was how many people in France are denied medical treatment, because the treatment doesn't meet goverment guidelines (such as the patient it "too old" at 70). My French-American doctor tells me that is why he came to the United States -- his conscience would no longer let him practice in France.

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Posted by Janna
a resident of Dublin
on Aug 1, 2012 at 7:52 pm

Janna is a registered user.

Hey Uncle Steve,

Have a source for your claim about France? That is, a reputable source? Or should we just rely on your lone anecdote?

Keep spouting that fear about Obamacare, maybe somebody will believe you.

Of course you're more concerned about Obama, he's going to beat Romney's ass in November.

Like this comment
Posted by hey
a resident of Another Pleasanton neighborhood
on Aug 1, 2012 at 11:50 pm

Hey Uncle Steve...
I think you could say the same about the insurance companies in the US....they deny care all the time to people that are sick. Oh wait... they don't 'deny it' ..... they deny paying for it. Whether or not you decide to get the care that you can't afford is YOUR choice.

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Posted by Arnold
a resident of Another Pleasanton neighborhood
on Aug 2, 2012 at 7:06 am

Actually, the bottom 50% of population -- the poor people -- pay a higher tax rate than does Mr. Romney. The bottom 50% pay approx 13% of their earnings to state sales tax, gas tax, cigarette and alcohol tax and so much more. But because Mr. Romney is a job-creating hero, as indicated by his widely studied tax returns, he doesn't need to pay more than 13%; in fact, as his tax returns will clearly show, he doesn't need to pay any taxes at all. Heck, that's what Swiss Bank Accounts are all about!

Now, what would you rather support: Romney's 400k dressage horse or some P-town teacher making a grandiose 70k in salary? See my point? Yet we continue to pay out to the teacher-union extortionists while paying no heed whatsoever to that wall of tsunami debt towering above us. With victory in the Olympic dressage event, Romney will win a 9000.00 gold medal. I've done the math! That's taking money from Britain and bringing it back to the United States. Bring back the gold, Mitt!

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Posted by liberalism is a disease
a resident of Birdland
on Aug 2, 2012 at 8:46 am

liberalism is a disease is a registered user.

troll, such shameless jealousy of a successful American success story. We'll teach that Romney guy for being successful in business.
In the meantime, let's re-elect an amateur who has never created a job, much less worked in one, spends most of his time either golfing, campaigning or traveling to meet his family in some far off tropical locastion on the taxpayer's dime.
Yeah, let's go there......and while you're at it, let's go to France for some of that 'free' medical care. No one else has to pick up the remaing tab for a subsidized $60 house's really, really free.

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Posted by Arnold
a resident of Another Pleasanton neighborhood
on Aug 2, 2012 at 9:09 am

I just love the honest, fact-based description of Obama the Grand and Great One that was provided above. The only thing missing is reference to bare feet on the golf course and picking vacation spots based upon quality and quantity of watermelons.

It is absolutely galling that a jealous public would begrudge a rich guy who refuses to pay his taxes for at least ten years.

Meanwhile, this Hawaii born nonAmerican is so dumb he thinks there's 57 states. Well, I have indisputable mathetical proof that he is wrong.

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Posted by liberalism is a disease
a resident of Birdland
on Aug 2, 2012 at 3:00 pm

liberalism is a disease is a registered user.

How about some proof of your assertion about unpaid taxes? Or should we just take your word for it?
While you're looking up your proof, I'll be looking up recipes for obamas favorite dish---dog. Next, I'll track down the report that came out yesterday about obamas ancestry and the research that pointed out he descended from slaves---white ones at that, from his mother's side of the family. Maybe this will finally prove he's 'authentic'....

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Posted by Janna
a resident of Dublin
on Aug 2, 2012 at 5:25 pm

Janna is a registered user.


An American success story? You admire a man who made his multi-millions (how ever much that actually is) from killing companies? Really, you admire him for putting people out of work?

No one is jealous, he's a vacuous, shallow man who thinks he doesn't actually have to apply for the job of president. He thinks he's entitled to it regardless of the fact that he can't relate to 98% of American citizens he wants to govern.

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Posted by Steve
a resident of Parkside
on Aug 2, 2012 at 9:02 pm

So, Janna, Obama can relate to whom? Not working Americans. He's never held a job. Not middle class Americans, he's always led a privileged life.
Romney ran the state of Mass. Obama voted present on most of the issues brought before him.
Entitlement is the signature of Obamas govt and his followers. Sucking the life out of productive, successful citizens. Obama can't run on his failed record, so he attacks Romney as an evil, rich guy. If Obama had any accomplishments to taut, no doubt he would rub everyone's nose in it, but since he has not made ah positive changes, he has to resort to class envy. He's acts like and childish little imp that thinks he deserves to reclaim this country's highest office, but it's only his enormous ego deluding him.

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Posted by Arnold
a resident of Another Pleasanton neighborhood
on Aug 3, 2012 at 7:41 am

Well folks, these are the facts:

Obama is a dog eater.

Being a college professor at the Univ of Chicago is not a real job.

ACA is not really an Obama accomplishment; nor is killing Osama bin Laden; nor does pulling us slowly but steadily out of the Bush-created depression count for anything.

No candidate for President should have to reveal his tax returns. All the others, Rep as well as Dem, did it because they were braggarts.

Most Americans will vote for Romney because he is likable, honest, transparent, has a lot of money, and has found a way to be a genuine patriot by not paying any taxes.

But, really, people, we digress. We need to return to the theme of entitlement sailors being in bed with politicians and how now, with everyone in bed with one another in an orgy of unsustainable entitlement spending, the dike is about to burst under a crescendo of tsunamic teacher salaries. Public school 'teachers' are our real enemy. The salamis and tsunamis are coming.

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Posted by Janna
a resident of Dublin
on Aug 3, 2012 at 9:35 am

Janna is a registered user.

Steve, you're losing it, seriously.

Repubs can't campaign on jobs (well, not now, they did in 2010 to get reelected) and they actively thwart any attempts to create them. They are trying to keep the economy down so they can win an election. This is what you consider patriotic, Steve and it's downright unAmerican.

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Posted by Ben Johansen
a resident of Birdland
on Aug 3, 2012 at 10:23 am

Well, apparently a writer above believes everything he reads. Love how a hack web site says Romney didn't pay taxes and the libs run with it. So why don't you run with the fact that Barry was never totally vetted by your party? That he grew up with socialists grandparents in Hawaii. That he started his political career, if you actually can call it one since he was absent more than anyone in both the state and US senate, with a guy who tried to blow up government buildings and makes no bones about . Why has Barry never released his college information? Come on, you truly believe what is written about Romney, but never once actually tried to find anything out about who the guy you endorse. The man who claimed it would be the most transparent presidency in history. What a bunch of BS and lies. Dig a little deeper inside the man you love so much and if that's what you like or want to emulate, then I guess you do want to end up like all the European countries who have massive taxes , socialists ideas and still ask for bailouts because government is not answer to all of your ails or wants and free stuff is actually not free, someone's paid for it.

Like this comment
Posted by Mitt Supporter
a resident of Downtown
on Aug 3, 2012 at 11:33 am

I'm certain Mr. Mittens has paid taxes. He just doesn't want to show anybody his tax returns because they'll find fault, and Presidential candidates can't have the public finding fault. The best thing to do is keep matters secret.

I, personally, find this to be a good quality from a president. Keep anything that might be criticized secret. In my opinion, that's saving democracy from itself. And it helps my guy get elected or staying in office, too.

Meanwhile, we need to launch an Isso led investigation into all the low-income people who don't pay sales taxes or gas taxes or cigarette taxes. It seems they have found a way to avoid paying any taxes at all. Those studies that show that 13% of their income goes towards taxes must be wrong. Only people like my guy, Mr. Mittens, should be able to not pay any taxes.

Thank you, and good-bye.

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