Here's a little secret that many hospitals don't want you to know: the bill they send you is only an initial offer.
There is almost always room to negotiate, and in some cases you can get your bill reduced by as much as 90%, or even forgiven completely.
All it takes is knowing who to ask.
Hospital Financial Assistance
You may not have known that many hospitals – non-profits in particular – have financial assistance programs specifically designed to help people pay for medical care they wouldn't normally be able to afford.
And there are two situations where you're especially likely to qualify.
The first is if you're uninsured. In many cases, simply being uninsured can result in an automatic bill reduction, no matter your income. Those with lower incomes may qualify for even bigger reductions.
(Keep in mind that this isn't necessarily a reason to go without insurance. Insurance comes with many protections, such as max out of pocket costs and pre-negotiated rates for procedures that reduce the cost without any work on your end. Not to mention the penalties for being uninsured.)
2. Insured, but still owe a significant amount
The second is if you are insured but your insurance only covers part of the cost. The lower your income and the more of your bill you're responsible for, the more likely it is that you'll qualify for assistance.
Two Types of Financial Assistance
If you find yourself in one of those situations, there are two types of assistance you might be eligible for.
1. Bill reduction or forgiveness
The first is a bill reduction, or potentially even total forgiveness. This redditor got a $12,000 bill reduced to $1,500 by simply contacting the hospital’s billing department, and there are other stories in that thread from people with similar experiences. In general, the more difficult your circumstances the more you may get forgiven.
2. 0% interest repayment plan
The other type of assistance that most hospitals offer is a payment plan with 0% interest. These programs are often offered without any eligibility requirements, meaning anyone can enroll. And while they don't reduce your bill, they can make it easier to afford by spreading it out over a period of months instead of requiring a big payment up front.
In some cases you may be able to use a combination of the two by qualifying for a reduction and then paying the reduced bill over a number of months.
If your hospital does not offer a 0% repayment plan, but does accept credit cards, you can consider applying for a card with a 0% intro-APR on purchases. For example, if you apply for Chase Slate® (which you can do here, on Chase's website) you can save with a $0 introductory balance transfer fee and get 0% introductory APR for 15 months on purchases and balance transfers. During that period, the interest is waived (not deferred) — so you can pay for your hospital bill with the 0% card, and avoid costly interest and fees during the promotional period.
How to Get Financial Assistance from the Hospital
To see whether your qualify for financial assistance, the best thing to do is reach out to your hospital as quickly as possible once you have your bill in hand
"Just ask", says Pam Horack, CFP® and founder of Pathfinder Planning. "I have found that if you contact the hospital billing department about payment, they are more than willing to work with you."
Thomas Nitzsche from Clearpoint Credit Counseling Solutions agrees: "Act immediately upon receiving the bill and contact the billing department of the provider and ask to apply for financial aid, even if you think you make too much."
Figuring Out Who to Ask
To figure out who to contact, first look at your bill. There should be a phone number for the billing department right on it, and you can call them up and ask about financial assistance.
If that doesn't work, just Google "your hospital" + "financial assistance". That should bring you directly to their financial assistance program with contact information to get you started.
From there, simply follow their instructions and provide the information they need. Though Melanie Lockert, the founder of Dear Debt who three years ago had a $1,600 bill completely forgiven, acknowledges that the process can take some time.
“I was grateful that they covered everything,” Lockert said, “but I did have to hand over a lot of information: bank statements, tax info, pay stubs, and any other documentation to help my case. It took about two months for me to get the letter saying that everything was covered.”
If you run into any issues or are having trouble understanding your bills or organizing your financial situation, you might consider reaching out to a non-profit credit counseling service for help. The National Foundation for Credit Counseling (NFCC) is a good place to start.
How to Negotiate Your Medical Bill
What if you don't qualify for a bill reduction, or if the bill isn't reduced by as much as you'd like? What are your options then?
Pay in Cash (or with an FSA/HSA)
You may be able to negotiate a lower bill, especially if you can pay up front in cash.
“Sometimes doctor offices, hospitals, labs and other medical facilities will offer a discount if you pay your portion of the bill in full,” says Shanda Sullivan, CFP® and founder of Sullivan Financial Strategies. “I myself and a client have saved 5%-10% off of our medical bills. It never hurts to ask.”
Adds Horack, “When I have had large bills, I called and asked if I could get a discount for paying cash. They reduced my bill by 20% and I paid with my FSA [Flexible Spending Account].”
Research the Price at Other Hospitals
Another strategy is to research the average cost of the care you received using sites like Healthcare Bluebook, or even calling up other local hospitals. If your hospital is charging you more, you could use that information as leverage for getting your bill reduced.
The bottom line is this: you have a number of options when it comes to reducing your hospital bill. In many cases, the simple act of asking can save you a lot of money.
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