by Andrea Atkins

Don’t get overwhelmed by affordable, unpaid medical expenses. Try these 6 smart strategies to get help paying your medical bills and lower your balance.

The only thing scarier than getting very sick is feeling overwhelmed by unpaid medical bills. In a survey from Synchrony Financial, 52% of respondents said they have delayed elective healthcare or dental treatment because of cost. Before you panic, though, take a deep breath and understand that there may actually be a way to get help.

“Getting frustrated with medical bills is totally normal. I see it all the time,” says Martha K. (Marty) Bradt, a licensed health care advocate who runs Health Claims Concierge LLC in Rye, NY. “It’s often a long road to getting it all sorted out. Take a deep breath. It is difficult and it can be confusing, but you can do it.”

To get help paying for your medical bills, try the following steps.

1.  Follow up on your bills

According to Bradt, many people wind up with large medical bills because they didn’t understand their insurance plan to begin with. Before you go to the doctor you’ve chosen, make sure he or she is in your network. Don’t rely on what the receptionist tells you. Always double check with your insurance company. Make sure you understand the percentage of the bill that will be covered by your insurance. Know what your deductible is, and when you finally do get bills, make sure you understand them.

“Some people don’t understand that the provider will bill them $5,000 for a service. Then the insurance company says they’re going to cover $3,000 for the procedure. Of that $3,000, your share may be 50 or 60 percent,” Bradt explains. She adds that sometimes mistakes happen, so if the percentage is wrong, or the deductible has already been met, you’ll know it because you have been following up on your bills.

2.  Offer to pay today

If you are caught off guard by a large bill, call the doctor’s office and offer to pay today. If you owe $3,500, for example, you might say, “I can pay $2,500 today.” The doctor may be willing to take that amount because he or she does not want your account to go into collections, which will end up costing the physician money.

“If you’re already in collection, this is a very good strategy,” Bradt adds because the doctor doesn’t want to deal with a collections agent either. If you get a call from a collection agency, don’t talk to the agent. Instead, call the billing officer at the doctor’s office and be ready to negotiate then and there. “Say,’I’ll give you a credit card number right now for X dollars,'” Bradt recommends. You may be told they’ll take that amount but that you’ll be expected to start a payment plan for some portion of the remainder. Either way, it will keep you out of collections, which is very bad for your credit score.

3.  Show proof of income

If paying your bill is truly a hardship based on your limited income, you can appeal to a hospital or medical group for a rate cut by showing proof of income. Put all of your bills together so you are also able to demonstrate how much you owe. You will be asked for a W-2 form or for your income tax returns as proof of your hardship.

4. Being nasty gets you nothing

“Persistence and organization pays,” Bradt says. Keep your bills organized and know where every piece of paper is. You will benefit from finding a “friend” at the hospital, insurance company, or medical practice who is sympathetic to your cause. “You are more likely to find that friend if you speak politely, kindly, and with respect,” Bradt says. Always get a reference number for each call you make. Repeat what you’ve heard back to the agent, so that you know you understand it.

“If you have a group insurance plan through a large employer, go to the Human Resources Department. You may find that there is a benefits person whose job it is to help employees with medical care. He or she can call your insurance company on your behalf,” Bradt adds.

5.  Take advantage of online communication

Whether you’re enrolled in Medicare or a private insurance company, communicate your concerns via the provider’s website. “Using electronic communication is infinitely more efficient than calling and waiting on the phone,” Bradt says. “It’s trackable, and it’s right in front of you. If you need to, you can ask them another question at midnight (by using their website.)” You can lay out your case without getting mixed up by questions from the operator, and you’ll have a record of what got said when. You may be more successful at getting a bill reduced this way than by repeating your story over and over again to a different phone agent each time you call.

6.  Hire a claims advocate

Check out Claims.org to find a claims advocate who is a certified claims professional who can help you. These agents charge an hourly rate (somewhere between $100 and $165 per hour) and usually take a percentage of the savings, says Bradt, “It may be worth it if they can spot errors in billing, negotiate on your behalf, or if they find errors in the processing of the claim.”

3 Tips for Organizing Your Bills

As they arrive, file your bills in a file marked “unpaid.” Sometimes you’ll get a bill before the insurance company has received it. Don’t panic. “Labs are infamous for charging before it goes to insurance,” says Bradt. “Bills sometimes come six months later. It makes patients nuts. Your mechanic doesn’t do this. The furniture store doesn’t do this. But the healthcare industry does.”

Match your original bill to the Explanation of Benefits (the document from the insurance company which details what it has paid and what it won’t pay.) Staple the EOB to the original bill, and move it to a file marked EOBs. Make sure you understand what you owe. If you can pay it, do so immediately. If not, start a file for such bills, so you know where they are.

Once the bill is paid, move to a file called “settled.”

• Tips for Negotiating a Lower Hospital Bill
• Medical Expenses Medicare Doesn’t Cover
• Controlling Medical Costs in Retirement

Reviewed February 2024