Emily Laurence is a journalist, freelance writer, and certified health coach living in Raleigh, North Carolina. She specializes in writing about health, lifestyle, teen issues, and entertainment. Emily spent six years as an editor and writer at Well+Good, covering everything from food trends to serious issues like the opioid crisis in America, gun violence, and women being sexually abused in hospital settings.
If you've ever received health care in the U.S., there's a good chance that one of the first thoughts to pop into your head — while a nurse is drawing your blood, while you're lying in a hospital bed in pain, while you're at a prenatal appointment — is how much the service you're receiving is going to cost you.
In the U.S., the fear of costs associated with medical care is very real: According to a 2020 survey from the non-profit Kaiser Family Foundation (KFF), Americans worry about unexpected medical bills more than any other financial tool, with 65 percent reporting being very or somewhat worried about them. This anxiety isn't unfounded, either, as one in 10 adults in the U.S. has medical debt, according to another analysis from KFF.
Here's the good news: No matter how much your bills are totaling or the type of insurance you have — if you have coverage at all — there are ways you can reduce your debt, set up a manageable payment plan, and lower your future health-care costs so you don't have to choose between caring for your health and wellbeing or going into debt.
If you just received a bill for a trip to urgent care or a planned procedure that was much more costly than expected, consider these strategies to bring down the total charges or the amount you personally have to pay to the medical provider, facility, or lab.
When you receive any medical bill in the mail, the very first step you should take — whether you're insured or not — is to check for mistakes, says Caitlin Donovan, the senior director of public relations at the National Patient Advocate Foundation (NPAF), a non-profit dedicated to advocating for better access to affordable, quality medical care for all patients. Specifically, you should take a detailed look over the provided itemized list of medical services, checking for errors such as duplicate listings and verifying that all the services listed are something you actually received. These mistakes can be costly, and this happens more often than you might think: "About half of the medical bills we see at NPAF have a mistake in them," says Donovan.
If you have health-care coverage, it's important to have your Explanation of Benefits documents from your insurance company handy in order to check for other mistakes, says Donovan. These papers are not a bill, but rather a statement from your health insurance provider that breaks down what medical costs it will cover and what you'll be responsible for paying — so don't toss them in the trash as soon as you see the "this is not a bill" statement printed on them. (If you did end up tossing out your Explanation of Benefits documents, lost them, or never received them, call your insurance's member services number so they can resend them. Some providers will also provide the documents online if you have an account registered.) If you receive a subsequent bill from a hospital or provider that doesn't match the total on the corresponding Explanation of Benefits document, that's an indication there's an error with the bill.
If you do spot a mistake, call your medical provider (this isn't when you dispute a charge with your insurance company) and tell them that the total provided doesn't match what your insurance says you were expected to owe, says Donovan. In that case, you should be able to get the incorrect charges taken off your bill.
Once you're certain that your medical bills are error-free, the next step is figuring out how to pay what you do owe. Thanks to financial assistance programs, which are available at most hospitals and health centers that provide primary and urgent medical care, you may be able to get your bill down to a lesser amount or even not pay anything at all, says Ruth Lande, the vice president of hospital relations at RIP Medical Debt, a non-profit that helps abolish medical debt. "Go to the hospital's website and search for 'financial assistance,'" she says. "Then, you should find information on who to contact and how to apply."
Even if you think your income is "too high" to receive financial assistance, Lande recommends applying anyway — just make sure to put as much detail in your application as possible showing why the charges are too much for you to pay. In many cases, low-income individuals qualify for financial assistance solely based on their income, but individuals of a higher income may still receive support if they can prove they truly need it, says Lande. "Maybe you have a special needs child or are caring for a parent," she explains. "Whatever your circumstances are, share your story to make it clear that you cannot afford the medical bills." Even if you don't have any medical insurance, hospital financial assistance is still open to you, says Donovan.
Even if you can't obtain a reduced bill with financial assistance plans, you can still potentially cut costs by paying a decent portion of your bill soon after receiving it; medical providers will often lower the total amount in these instances, according to the experts. For example, you can offer to pay 25 percent of the charges right away if the total bill is reduced to a discounted amount. If you're not using a financial aid program, you may be able to negotiate a reduced monthly payment. If your medical provider is suggesting a monthly payment of $300, for instance, but you can pay only $150 a month — even if it's over a longer period of time — chat with them about your options.
What you absolutely don't want to do is pay for your medical bills using a credit card, says Lande. "Credit card bills have high-interest rates, so if you pay for your medical bills using a credit card, you actually end up paying more than what you owe [over time]," she says.
Your medical provider isn't your only option when it comes to receiving financial assistance. There may be resources within your community, such as a local church or a non-profit, that can provide financial help for medical bills or other general expenses — which are just as important to consider, says Donovan. For example, if there's a local non-profit that can help cover a portion of your rent or pay for childcare, the money you would typically allot for those expenses can go toward paying your medical bills.
Additionally, there are many organizations that offer financial assistance for folks dealing with specific medical concerns, such as individuals who are undergoing cancer treatment, says Donovan. To find one that may provide aid for people in your specific situation, look to the NPAF's financial assistance directory, which includes resources for helping with the costs of child care, transportation, caregiver support, and more. Users can search by state, medical diagnosis, and the type of assistance needed.
65 percent of Americans are very or somewhat worried about unexpected medical bills.
All the above steps are options anyone can take for medical bills they have received, including bills from urgent care or the emergency room. But maybe you haven't sought out the care you know you need because of the expected costs. Luckily, though, there are steps you can take in advance to cut down on what you'll have to pay for future care.
The vast majority of health insurance plans cover an annual check-up. But that doesn't mean the appointment will be free, says Donovan; you may still have to pay a co-pay or deductibles for any lab work or tests that are done. Just be sure to use your insurance company's website to search for an in-network provider to reduce costs. (That said, the bills from check-ups aren't typically the type of bills people freak out over, she adds.)
If you're uninsured but need or would like a physical, do a Google search for community health clinics in your area. One of the main purposes of community health clinics is to serve people who are uninsured, so the services are often discounted or free. (BTW, these clinics also often provide prenatal care and vaccinations for infants.)
Maybe you know that you need to have surgery or another type of medical procedure — something that you're worried is going to cost you a pretty penny. In this instance, you can apply for financial assistance ahead of time, says Lande. "You can even apply at different hospitals to see which one will offer you more help," she adds. If you don't have medical insurance but need a procedure, you can still apply for financial assistance from multiple hospitals to see which one offers the biggest discount. As with routine checkups, Lande recommends searching for doctors and medical centers that are in-network, which will also cut down on costs.
As of January 1, 2022, the No Surprises Act, a policy that bans surprise bills from out-of-network providers or emergency services without prior authorization, is also in effect, says Donovan. As a result of this policy, you should be able to ask for a Good Faith Estimate, which lays out how much your procedure will cost, before it happens, she says. You are entitled to a Good Faith Estimate whether you have health insurance or not, but health-care providers are required to provide this to uninsured patients, according to information published by the Children's Hospital of Philadelphia. (BTW, the No Surprises Act doesn't apply to folks with Medicare or Medicaid since these programs already protect them from surprise medical bills.)
If you ask for a Good Faith Estimate and the final bill you receive is $400 more than the estimated cost, you have grounds to dispute the bill. Donovan recommends getting the Good Faith Estimate mailed or emailed to you so you have a paper trail, which will make it easier to dispute.
The vast majority of insurance plans are required to cover childbirth, but again, this doesn't mean that giving birth is necessarily free, says Donovan. Co-pays and deductibles still apply. If you're getting your insurance from the independent market and plan on getting pregnant in the next year, be sure to research the plan you're thinking of buying; not all independent insurance plans cover childbirth costs. Once you get your bills in the mail, Donovan recommends checking them for errors, as you may be being charged more than you should be.
If you are pregnant and don't have insurance, you may be eligible for free or discounted prenatal care from the government or a non-profit such as Planned Parenthood. To find out what is available in your area, call 1-800-311-BABY (2229), a toll-free number that will connect you to your local health department. As for the cost of childbirth itself, you can apply for financial assistance as you would for other medical procedures if you're uninsured.
If you're rehabbing from an injury, are receiving ongoing cancer treatment, or are in another medical situation causing regular appointments to fill up your calendar, Lande recommends seeing if you can receive your treatment at a hospital rather than a freestanding clinic. The reason for this is that it will be easier to fold the financial assistance for ongoing treatment into a plan you have already established with the hospital at which you're likely receiving other care, she says. Otherwise, you'll have to apply for financial assistance with the freestanding clinic in addition to the hospital. FTR, obtaining financial assistance at a hospital and a separate clinic can be done, but it's just an extra step, says Lande. And again, use your medical insurance website to search for care that is in-network.
If you have cancer or another chronic condition, you can also reach out to organizations that are specific to your diagnosis and offer financial assistance for medical bills and costs related to treatment, Lande recommends. For example, the Leukemia & Lymphoma Society offers financial aid to help with insurance premiums and co-pays for prescription drugs, tests, and more for individuals with blood cancer. Most importantly, "plan ahead as much as possible and get someone to help you navigate the costs," adds Donovan. "If you have cancer or another chronic condition, you are likely going to be tired, and trying to deal with medical bills on top of how you will be feeling is going to be a lot to handle." If there isn't a loved one in your life who can help you navigate your bills, ask your medical provider about working with a patient advocate who can help with medical billing and insurance issues.
Additionally, some medical providers will offer a discount if you're able to pay for a portion of your ongoing appointments upfront, says Donovan. All of the options explained before — including applying for financial assistance and seeking outside help — apply here, too, even if you are uninsured.
If you want to start therapy or pick it back up but are worried about the price tag, Lande suggests using your medical insurance's website to search for an in-network therapist. If you still can't afford the cost of therapy, consider seeking out non-profits that help cover the costs, such as American Psychoanalytic Association and Mental Health America. If you are on Medicaid, your insurance covers therapy — so long as you have a diagnosis and a medical prescription for a certain type of therapy, which your primary care doctor can provide. Another option: Sign up for virtual therapy appointments, which are often less expensive than in-person appointments, says Lande, and many organizations and companies offer these services to uninsured individuals. Regardless of insurance status, you can also look into providers who offer sliding-scale payment options, as the price of the services you're seeking may be reduced depending on your income.
There's no getting around the fact that health care in the U.S. is expensive. But no matter what you need medical care for, you shouldn't let the potential costs stop you from seeking the help you need.