There may not be a scarier field to navigate as a consumer than in the health insurance sector . Dealing with medical bills can be particularly stressful. You may already feel vulnerable after giving your doctor your health and safety. You may even recover from an operation. Attempting to sort out medical bills that appear to be written in a foreign language only aggravates the situation.
In a nationwide representation Pew Research Center surveyed 2,537 US adults, 83% of respondents High treatment costs that made high-quality medical care unaffordable were "a big problem." This can delay the search for treatment because it fears financial repercussions. But sometimes you need expensive precaution or need to be in an emergency situation so you have medical bills that can lead to frustration and anxiety .
Before we look at the advice of experts in navigating big medical bills, it is important to acknowledge that even doing so is a privilege. Usually this takes a lot of time and energy (often during normal business hours) and is generally easier if you have health insurance. If you are LGBTQ + a woman, a person of color, a disability, or some other (or many) fringe groups, it can be even more difficult to make people listen when you commit to it yourself. While many of the tips here are wide, some of them specifically address these concerns.
In this regard, review the recommendations of Health Equity advocates and health insurance experts on how to avoid large medical bills or, if necessary, engage with them afterwards.
. 1 Try to estimate your costs in advance.
If you know that you have medical treatment and are reassured, talk to your doctors the hospital and your insurance company A playground of what you owe.
First ask your provider and your hospital if they are on the network. If you are on the network, you accept your insurance, which is likely to translate into a much lower bill. Check with your insurance company exactly what they say and make sure you receive information on all of the major service providers involved in your intervention (such as your surgeon, anesthetist, etc.). ), as some of them may have different insurance policies. (It may be easier to first ask the hospital if they can verify that all the providers involved are on the network for you.)
Then ask your family doctor and the hospital about as many details as possible about the procedure You have and what it could cost. If you have an insurance policy, call them and ask them to help you reduce the cost of care based on what your doctor and hospital have told you.
If English is not your first language, you have the right to speak to someone who can communicate clearly in your main language. While the patient's legal document may vary from hospital to hospital, one of the overriding requirements is that people have access to health services in a language they are comfortable with, which may require an interpreter.
Beyond There are online prizes to help you determine the standard rate for your procedure. FAIR Health is a national option, and you can search Google for more local options.
However, you can not use this information as a guarantee of what you pay for. "Often, the doctor, the hospital and the insurance company do not know what the [others] is doing," says Jane Kaye, a former finance director in two New Jersey hospitals, to SELF. This can lead to different estimates from different sources. In addition, your providers might be able to customize aspects of your treatment.
"You may have a poor response to a particular drug [or] that requires additional treatment that would further increase your bill," says Kaye, a hospital accounting consultant at HealthCare Finance Advisors .
However, Kaye even confirms that your hospital and doctors accept your insurance, and you get an idea of what your procedural costs are for a better idea of what to expect.
. 2 If you are uninsured, try signing up for a plan.
This is another step you could try if you have some time to prepare before a procedure. Health insurance is often a worthwhile investment, but it is a particularly good idea to know that you will be visiting and leaving the doctor's office in the near future.
If you can not afford insurance, look if you qualify for Medicaid which assures many people and low-income families. Many people qualify for Medicaid and do not know it, says Elisabeth Ryden-Benjamin, Vice President of Health Initiatives at the Community Service Society in New York an anti-poverty advocacy organization serving New Yorkers, to SELF. The qualification is based on your income and your family size. So you see if you are eligible.
Qualifying for Medicaid can drastically reduce the amount you owe, as the legal requirements for Medicaid beneficiaries are insufficient. 5 percent of the income of a family.
If you are not eligible for Medicaid, but recently had a so-called qualifying life event (divorce, marriage, birth of a child, lost your job, etc.), you can try contacting the health insurance of your State to register. Normally, you can only enroll in a marketplace during open enrollment (usually November and December, although it takes longer, depending on which state you live in), but these situations will give you an exception.
If you are only enrolling in health insurance At the moment, no option is available. You can contact a low-cost or free health center to get the care you need. Federal Health Centers supply underserved populations, often on a sliding scale. Here in your area you will find .
. 3 Call the Hospital Accounting Department to confirm your insurance information.
So you've researched, maybe even taken out a health insurance if you have not had them, and you're still staring at a bill that does not seem to be quite right. They are not alone: According to a nationwide representation of 2018 of the Kaiser Family Foundation of 1,201 persons, ages 18+, 39 percent of insured adults had a doctor's bill that exceeded expectations last year. 19659024] Receiving the bill may seem catastrophic, but experts agree that you should not panic or pay for it immediately. "The biggest mistake people make is that they see the bill and pay automatically," says Claire McAndrew, director of Campaigns and Partnerships at Families USA a health care association, to SELF. "Consumers are so exhausted that they think they have no recourse. However, there are often solutions. "
Filing the Right Insurance on Accounting in the Hospital is a good first step. Health technology is known to be outdated, so it is plausible that the high number you see is a mistake. "There are many places where things could go wrong," says Kaye. "If you showed them your insurance card, you might have entered something wrong. Even the first misstep can lead to problems. "
. 4 Call your insurer to better understand your bill.
If you have not unsubscribed, the health insurance companies will send you a Declaration of Performance (EOB) after visiting a doctor or hospital Explain what exactly they will cover. Parsing through your bill and EOB can be overwhelming. "I teach Rutgers funding for health care, and I bring real-life bills to show students how complicated this is," Kaye says.
To make things easier for you, have someone at your insurance company read through the numbers and numbers on your bill and EOB codes. This can help to ensure that they cover everything they are supposed to do, and that you have not been billed for a service that you did not receive by mistake.
If you're on Medicaid, you should be protected from sticker shock by the federal protective measures we mentioned above. So, if all costs seem exorbitant, contact your Medicaid office to see if your bill is correct.
. 5 Ask the hospital for a premium discount or a payment plan.
If a medical bill seems correct but is still too expensive for you, ask at the Hospital for a premium discount, if paid will reduce your fee if you pay the fees immediately in full. Not all vendors offer this, but most do, says Kaye, adding that the rebate is often 10 to 20 percent.
If you are unable to fully pay your bill, ask the billing department of the hospital for a payment plan. This may be a multi-year plan, and experts point out that sometimes you can only pay $ 5 a month. In hospitals, you'd rather have someone willing to pay a little instead of ignoring the bill altogether, says Kaye. So you're usually ready to work with you on a plan you can manage.
Even if you embark on a plan When you set a certain amount per month, it's always worth asking if you're eligible for additional discounts on your bill, says Ryden-Benjamin. This is especially important if you are uninsured, as many hospitals offer charities that greatly reduce (or even eliminate) your bill when your income is low enough or your situation is extreme enough.
. 6 File a complaint with your insurance company.
If you can not reach agreement on a payment plan with the hospital, or still believe that your insurance should provide more coverage, you may wish to lodge a complaint with your insurer. Each insurer handles complaints differently, but you often find steps for the appeal process on the company's website, such as Aetna's Guide Here .
If your appeal is denied, Ryden-Benjamin recommends a retry. "It's a pain in the neck for [hospitals and insurers] to move on with you," says Ryden-Benjamin, meaning that sometimes stubborn behavior is enough to make your appeal and reduce your costs.
Let the hospital know, as soon as you have appealed your insurance, says Kaye. In some hospitals, your bill will be put on hold so that it will not expect any payments at this time. Kaye does not say all, but the three major US credit agencies grant a 180-day grace period before an unpaid health insurance affects your credit report. That's about six months, which will give you some leeway to fight for a fairer bill.
Further information concerning the opposition to an insurance claim.
. 7 Find advocates to fight or even pay for you.
Hospitals have Patient Representatives to help them pave the way through the complex world of healthcare. Ask to speak with one, explain your situation, and see if they are able to provide financial advice.
There are also outside lawyer organizations that can help you figure out whether your fees are fair, or whether you can work with them in appeals to help cover your expenses.
For example, Community Health Advocates a free service operated by the Community Service Society of New York, works with privately insured, publicly insured, and uninsured individuals to navigate the minefield of health bills. This may include lodging a complaint on behalf of a consumer, and its free helpline (888-614-5400) offers over 170 languages in .
Research similar consumer assistance programs in your country and in your area. If you live in a state or region with limited resources, your State Insurance Department may prove useful. "You can contact the hospital and your insurance company to act as a lawyer," says McAndrew.
There are also nationwide organizations such as the National Patient Advocate Foundation which supports free attorneys on behalf of patients. They are related to the Co-Pay Assistance Program of the Patients' Advocacy and the Financial Assistance Fund which provide financial support to both individuals who meet certain income-related and health-related criteria. 19659045] The advocate route may be a particularly good option for non-English speaking people or people with marginalized identities who are more prone to poor health care treatment. It could be easier to have a lawyer for you than to do all this work yourself.
. 8 Call your elected representatives.
Two senators and a representative of the House of Representatives filed a law against surprising medical bills last year, and President Trump had expressed a desire in January to ensure that people know exactly how much a trial can cost before It's unclear how this would work because, as Kaye says, hospital care tends to have many variables. However, McAndrew points out that this is considered one of the only health issues for both parties in the government.
If you get a surprisingly high bill, call and inform your elected representatives, McAndrew says. Although it is unlikely to affect your current bill, your elected officials may be forced to act. If anyone who received a surprise bill made that call, it could bring us closer to a more transparent health insurance bill.