How to Negotiate Medical Bills Without Making Yourself Sick

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U.S. healthcare can cost an arm and a leg. 

You’re fighting a serious medical ailment or working to recover from an injury, only to find a stack of medical bills waiting for you at home. Knowing that there’s not enough money in your bank account to pay the medical bills, you worry that you may become one of the million or so U.S. adults who claim bankruptcy every year.

It doesn’t help to know that medical bankruptcy is nearly unheard of outside of the U.S. Other than China, every other developed country in the world has a single-payer healthcare system. Medical costs for residents of those countries are financed by taxes rather than premium-paid insurance. There are no out-of-pocket costs for medical care and no need to declare bankruptcy due to medical care.

But here you are, faced with medical debt. Fortunately, medical debt in the U.S. is negotiable. It can be lowered or even wiped out entirely. Here are the steps you’ll need to take to whittle away at those bills.

Familiarize yourself with the debt

One of the least enjoyable things you’ll ever do is to pore over an itemized bill for your medical care. If you’ve received services from several medical providers, ask for an itemized statement from each.

You’re looking for billing errors. For example, a statement may list another patient’s name, incorrect insurance information, or incorrect procedure codes. You may also see two charges for the same procedure. Circle anything that looks “off.”

Note: You may not feel physically or emotionally ready to deal with medical bills. If you have someone in your life who can help you, ask them to look for errors and to circle anything that seems odd to them.

Familiarizing yourself with medical bills is not meant to be a practice in torture. Rather, knowing how much you owe is the foundation for coming up with an alternative payment plan.

Determine your bottom line

Before calling a hospital or medical provider, sit down with your budget and determine how much you can afford to pay. For example, some medical providers will settle for a lower amount if you’re willing to make an upfront lump-sum payment.

If you can’t afford an upfront payment, decide whether you can afford to make a monthly payment for a fixed period of time. For example, you may suggest making a $200 payment each month for four years.

If you absolutely cannot afford to pay the debt, you’ll want to share that information with the medical provider.

Negotiating

This is where you’re going to reach out to the hospital or medical provider. Stay calm, remain polite, and never underestimate the power of empathy. You’ll be dealing with real people in the billing department, folks who know how tough it can be to cover medical costs. Lay your situation out for them, and request their assistance.

If you discovered any mistakes in billing, now is a good time to review those errors with the billing department and ask that they be removed from the total due.Find out if you’re eligible for Medicaid. The majority of states offer three months of retroactive coverage for those who qualify for Medicaid but have not applied. How well this works for you will depend upon where you live. For example, state legislatures in a handful of states — like Florida, Georgia, Indiana, Iowa, Oklahoma, Tennessee, and Utah — have eliminated the retroactive aspect of Medicaid, except for a select portion of the population.Ask about any financial assistance programs offered to low-income patients. There are federal requirements for nonprofit hospitals to provide this assistance.Ask about the cash price for your procedures or stay. The cash price is almost always lower than the price charged to insurance companies.If you have the money to make a lump-sum payment, now would be a good time to find out if doing so will lower the bill.If you can’t make a lump-sum payment but can manage monthly payments for a fixed term, ask that the billing department set you up on a payment plan. Aim to pay zero interest, but if that’s not possible, ask for the lowest possible interest rate.Billing departments are accustomed to negotiating, and most are good about walking patients through their options. However, if the person you’re speaking with is rude, seems disinterested, or asks about things like how much you have in your savings account, escalate the situation by asking to speak with their supervisor. You may end up telling your story several times, but it pays to work with someone who can help.You also have the option of turning to a patient advocacy organization. For example, you can contact the Patient Advocate Foundation at PatientAdvocate.org or your state or local consumer protection agency at USA.gov/State-Consumer.

As of 2023, medical debt is a reality for millions of Americans. Until the day we can find a better way to cover the cost of medical care, we’ll have to depend on a compassionate person on the other end of the phone line to help us erase the debt.

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