Health care in the United States is notoriously expensive. Even with health insurance coverage, the out-of-pocket costs can add up quickly. In a 2019 survey from the Commonwealth Fund, a private foundation that promotes better access to health care, 23% of respondents said they couldn’t pay their medical bills immediately, so they’re paying off the debt over time. And 46% of those people are paying for care they received more than one year ago.
Several strategies may offer relief from burdensome medical bills, regardless of your income. In this story, we explore ways to get assistance, negotiate payments, and use other techniques to take control of these debts. And if you need help with any of this, we’ll point you toward reputable resources.
Don’t Ignore the Bills
While snowballing medical debts can cause distress, it’s critical to monitor your health care costs and at least acknowledge bills as they arrive. You may have an opportunity to deal with the debts—even if you don’t have the funds to pay them off right now—and prevent things from getting worse.
Health care providers typically don’t report your payments to credit bureaus. And if they do—or if they send your account to a collection agency—there’s a six-month waiting period before the debt appears on your credit reports, so you have some time. But after that, unpaid bills can appear on your credit reports and hurt your credit scores. The damage can linger, because those negative entries may remain on your reports for seven years.
Be sure to distinguish between bills and explanations of benefits (EOBs). Sometimes it’s hard to tell the difference. A bill is a request for payment, while an EOB is an informational document explaining how much the provider is billing your insurance company. Look for the words “This is not a bill” to identify an EOB.
Make Sure Insurance Won’t Cover It
Sometimes insurance companies ask you to pay charges you’re not responsible for. Don’t just assume every bill is accurate. Medical billing is complicated, and there are several opportunities for mistakes that can lead to a denial of valid claims. If you suspect you’re being billed incorrectly, contact your insurer immediately.
You can dispute bills with your insurance company and request an internal review of your appeal. If the insurer refuses to budge, you have the right to appeal with an independent third party.
Check Whether You Qualify for Medicaid
Medicaid provides health coverage for people with lower incomes. It’s the largest coverage provider in the U.S. If you qualify for benefits, Medicaid could offer vital relief. Eligibility may depend on the state you live in, so check with Medicaid for details.
In some cases, Medicaid can pay for medical bills retroactively. You may be able to get bills covered for the previous three months, so it’s critical to act quickly if you think you might qualify.
Negotiate Medical Debt Relief
It may be possible to pay less than you owe and settle your debt by offering to pay what you can afford right now. Medical providers and debt collectors may be willing to accept your offer rather than trying to collect (possibly unsuccessfully) later.
Start by negotiating with your medical care provider. Medical offices may be willing to work with you and take less than they originally billed. Doing so gives them revenue today, and they won’t have to sell the debt to a debt collector for a fraction of the total amount you owe. Plus, if you can prevent your debt from going to a collection agency, you might minimize damage to your credit score.
Contact your doctor’s billing department to try to work out an arrangement. You may be able to negotiate a lump-sum payment for less than you owe or a series of smaller monthly payments. You also can ask about medical-bill financial assistance programs, which you might qualify for by demonstrating financial need. No matter who you negotiate with, get any agreement in writing.
If your debt is with a collection agency, you still may be able to negotiate. Gather information about your finances and propose a solution that works with your budget. If you need help, you can seek the help of a professional (more on that below). Again, get everything in writing before you send any money.
Consolidate Medical Debt
If you have unpaid medical bills with several creditors, it could make sense to consolidate those debts. When you consolidate, you combine all of your loans into one new loan, ideally with better terms. The result is a single payment that may be easier to manage.
Popular options for medical debt consolidation include personal loans and promotional credit card offers, but make sure that taking one of these options doesn't threaten to worsen your debt load with high interest charges or fees later on if you can't make the payments.
With a personal loan, you borrow the amount you need to pay off all your debts, shifting the loan balances to the personal loan. You typically pay off the loan over one to five years, but terms vary from lender to lender. During that time, you often have a fixed rate, which keeps your payments level and predictable.
Credit Card Promotions
Credit card promotions might offer 0% interest for a limited time. If you qualify for those offers and can pay off the balance before the card starts charging interest, you can avoid additional interest charges. However, you may need to pay a balance transfer (or similar) fee to use a credit card promotion.
Deal With Collections
Debt collectors may try to collect money, even when you’re unable to pay. If you want to prevent persistent collectors from asking for money, you can send a cease-and-desist request. This action does not cancel the debt—the loan balance still exists, even if collectors stop calling—but it may provide some peace of mind while you figure things out.
Debt collectors may still send certain communications after you request that they stop collection efforts. However, they should not continue to call and ask for payment.
Get Help With Your Medical Debt
If you’re overwhelmed by medical debts, you may benefit from professional help. Nonprofit debt counseling agencies can help you understand your situation and may be able to set up a debt management plan with creditors. With that approach, you might make a single monthly payment and potentially get fee waivers or lower rates on your debt. See our list of credit counseling agencies for ideas on who to contact.
In more extreme cases, hiring a debt negotiation company or bankruptcy attorney may be appropriate. However, those tactics are best kept as a last resort, because they can have a significant long-term negative impact on your credit score. To get help from a debt negotiator, start with our list of the best debt relief companies available nationwide.