Getting sick or hurt is hard enough. But when a big bill shows up in your mailbox, things can go from stressful to overwhelming in the blink of an eye. And you’re in good company if you’ve ever balked at the high prices on your medical bills.
In the United States, medical debts are a top reason people fall into debt, or even file personal bankruptcy. But there’s good news: You can protect yourself before the bills arrive, and there are ways to get help if you’re already feeling buried. This guide will walk you through both, step by step.
Step 1: Be Prepared Before the Bill Shows Up
Like death and taxes, medical bills are one of American life’s inevitabilities. But you can avoid a lot of medical debt just by knowing a few key things ahead of time.
Understand Your Health Insurance
Before you get care, make sure you understand your health insurance. Refresh your memory on these common medical plan terms to start:
- Deductible: What you pay out of your own pocket before insurance starts to help
- Co-pay: A flat fee you pay for visits (like $25 for a doctor visit)
- In-network: These are doctors and hospitals your insurance company agrees to cover. They usually cost a lot less than out-of-network ones.
Choose In-Network Providers
Before you schedule an appointment, check if your doctor or hospital is in-network. This one step can save you hundreds or even thousands of dollars. As important as understanding your health plan is, it’s equally important to know your rights as a patient, and to be on the lookout for improper billing practices.
Ask for Cost Estimates
If you’re getting a test or surgery, ask for a price estimate. Many providers will give you a rough number. It’s not exact, but it helps you plan ahead. A good approach to getting as best a picture as you can is to ask your doctor’s office for the CPT codes for your upcoming test or procedure. Call your healthcare provider with these codes in hand, and take notes on what you’re told. You’ll be able to use these estimates for comparison later.
Step 2: Understand the Bill
When the bill comes, don’t panic — and don’t pay it right away. First, make sure it’s correct.
Read Your Explanation of Benefits (EOB)
Your insurance company sends this document after a visit. It explains what they paid and what you still owe. Compare it to your provider’s bill.
Ask for an Itemized Bill
Call the billing office and ask for a detailed list of all charges. Sometimes you’ll see mistakes like:
- Duplicate charges
- Wrong dates
- Services you didn’t receive
These errors can be fixed—and save you money. Use those CPT codes you got earlier to check that insurance is billing you for the correct procedure.
Step 3: Negotiate Your Bill
Medical bills aren’t set in stone. In fact, hospital systems, providers and insurers can be open to negotiating — or even covering — parts or the entirety of your debt. Of course, it depends as much as who you are as it does the procedures covered, who performed them and where they were performed.
If you need help with the bill, the best thing you can do is call and start looking into support. Often, hospital networks will offer “charity care” services for individuals with lower incomes — reach out to your hospital’s billing network to learn what options may be available to you.
Step 4: Find Help If You Can’t Pay
If the bill is more than you can manage, don’t ignore it. Help is out there.
Government Help
Programs like Medicaid or Medicare Savings Programs may help cover your care. If you qualify, you could see big savings.
Patient Advocates
Patient advocates are people who help patients untangle medical bills and access affordable care. If you’re chronically ill, suffering from a major disease or had an expensive emergency room visit, a patient advocate can help you:
- Dispute incorrect charges
- Negotiate bills on your behalf
- Help you apply for assistance programs
Be Careful with Medical Credit Cards
Cards like CareCredit are designed to help pay medical bills—but they come with a catch. If you don’t pay them off in full by the end of the promotional period, interest charges (often 26% or higher) kick in. That means any savings you might have enjoyed will be severely undercut.
How Debt Consolidation Can Help
If you’re juggling medical bills, credit cards and other debts, consolidating them into a single lower monthly payment could help. Our highly-rated debt consolidation program can:
- Reduce your monthly bills
- Reduce the impact of interest
- Help you become debt-free in 24–48 months
Focus on Healing, Not Just the Bill
Dealing with medical bills can be overwhelming. But you’re not powerless. By understanding your insurance, checking your bills carefully, asking the right questions and knowing where to find help, you can take back control of your finances. You have access to options, and they may give you space to focus on what matters most: getting well.