Medical bills can become difficult to manage when a person faces hospitalization, surgery, cancer treatment, prescription medications, emergency care or a long-term medical condition.
For many Americans, the amount left after health insurance can still be substantial. Deductibles, copayments, coinsurance and services that are not fully covered can create financial pressure for individuals and families.
The good news is that patients who cannot afford their medical bills may have several options to explore before turning to high-interest credit cards or other expensive forms of borrowing.
Depending on your circumstances, help may be available through health insurance programs, hospital financial assistance, government programs, charity care, payment plans, nonprofit organizations and medical debt assistance programs.
The first step is to understand the bill and determine which resources may apply to your situation.
What Should I Do If I Cannot Afford My Medical Bills?
If you cannot afford a medical bill, do not simply ignore it.
The Consumer Financial Protection Bureau recommends first checking whether the bill is accurate and determining whether you actually owe the amount being requested. Insurance coverage, financial assistance and federal or state protections can affect how much a patient is responsible for paying.
A practical first step is to:
- Review the medical bill.
- Compare it with your insurance explanation of benefits.
- Ask the provider to explain anything you do not understand.
- Ask about financial assistance or charity care.
- Ask whether the bill can be reduced.
- Ask about an interest-free payment plan.
- Investigate government programs for which you may qualify.
- Look for nonprofit assistance.
- Consider other financing only after reviewing these options.
CMS also recommends checking medical bills for errors and discussing payment options directly with the healthcare provider.
Can a Hospital Help Pay or Reduce My Medical Bill?
In some circumstances, yes.
Nonprofit hospitals must provide financial assistance to eligible patients who cannot afford to pay. This assistance may sometimes be called charity care.
Financial assistance policies vary by hospital, so patients should contact the billing or financial assistance department directly.
Ask the hospital:
- Do you have a financial assistance program?
- Do I qualify for charity care?
- What income requirements apply?
- What documents do I need?
- Is there a deadline to apply?
- Can I apply after receiving the bill?
- Can my bill be reduced?
- Is an interest-free payment plan available?
CMS recommends obtaining the hospital’s financial assistance policy and reviewing its eligibility requirements, application process and deadlines.
How Do I Apply for Hospital Financial Assistance?
The application process depends on the hospital.
Generally, you should start by contacting the hospital’s billing department and requesting its Financial Assistance Policy.
The hospital may ask you for information such as:
- Household income
- Household size
- Tax documents
- Pay stubs
- Bank statements
- Insurance information
- Medical bills
- Proof of financial hardship
Not every hospital requires the same documentation.
After submitting an application, ask how long the review will take and what happens to your medical bill while the application is being processed.
If the bill has already been sent to collections, CMS recommends informing the debt collector that you are applying for financial assistance and asking whether collection activity can be paused while the application is reviewed.
Can I Negotiate a Medical Bill?
You can ask your healthcare provider whether the bill can be reduced.
CMS specifically recommends contacting the provider if you cannot afford the amount being charged. Providers or billing departments may sometimes reduce the price or offer payment plans.
Before making the call, review the bill carefully.
Check for:
- Duplicate charges
- Services you did not receive
- Incorrect dates
- Incorrect insurance payments
- Charges you do not understand
- Services that should have been covered by insurance
If something appears incorrect, ask the provider to investigate it.
Can I Set Up a Payment Plan for Medical Bills?
Many healthcare providers offer payment arrangements.
A payment plan allows a patient to divide the amount owed into multiple payments instead of paying the entire balance immediately.
Before accepting a payment plan, ask:
Is the plan interest-free?
Are there administrative fees?
How much will I pay each month?
How long will the payment plan last?
What happens if I miss a payment?
The CFPB recommends asking about interest-free repayment plans before using a credit card or medical credit card to pay a medical bill.
An interest-free arrangement may cost less than carrying a large balance on a high-interest credit card.
What Government Programs Can Help With Medical Bills?
Several government programs may help eligible individuals with healthcare expenses.
According to USA.gov, potential programs include:
- Medicaid
- Children’s Health Insurance Program (CHIP)
- Medicare
- Affordable Care Act Marketplace coverage
- COBRA
- Medicare Savings Programs
- Medicare Extra Help
Eligibility can depend on factors such as income, age, employment status, household circumstances and qualifying health conditions.
Because eligibility requirements vary, patients should check the official program requirements rather than assuming they qualify or do not qualify.
Can Medicaid Help With Medical Bills?
Medicaid is a federal and state program that provides health coverage to eligible low-income individuals and families.
Eligibility and covered services vary by state.
If you are experiencing financial difficulty and do not have adequate health coverage, it may be worth checking whether you qualify for Medicaid or another government health coverage program.
USA.gov provides information about eligibility and applications for government health insurance programs.
Can Medicare Help With Medical Expenses?
Medicare can help eligible individuals pay for covered healthcare services.
For people who have Medicare and limited income or resources, Medicare Savings Programs may also help with certain Medicare costs, including premiums and potentially deductibles, coinsurance and copayments, depending on the program.
People with Medicare prescription drug coverage may also qualify for Extra Help, which can reduce certain Part D prescription costs.
What If I Have Medical Bills After Insurance Pays?
Having health insurance does not necessarily mean that all medical expenses will be paid.
You may still have:
- Deductibles
- Copayments
- Coinsurance
- Out-of-network expenses
- Non-covered services
- Prescription costs
- Other eligible patient expenses
If you still owe money after insurance pays, ask the provider about financial assistance and payment plans.
USA.gov specifically identifies charity care and Medicare assistance programs as potential resources for people who continue to have medical expenses after insurance.
What If I Do Not Have Health Insurance?
People without health insurance may still have options.
CMS recommends asking about financial assistance and checking whether the provider offers a payment plan or reduced bill.
If you are scheduling medical care and do not have insurance, you may also be entitled to receive a Good Faith Estimate for expected charges in applicable circumstances.
Under federal rules, if you receive a Good Faith Estimate and the final bill is at least $400 more than the estimate from a provider, you may have a right to dispute the bill, subject to the applicable requirements.
What Is a Good Faith Estimate?
A Good Faith Estimate is an estimate of expected healthcare charges provided to certain uninsured or self-pay patients before scheduled care.
It can help patients understand potential costs before receiving treatment.
CMS recommends keeping the estimate and comparing it with the final medical bill.
However, Good Faith Estimate rules have exceptions, including certain emergency situations and care scheduled with less than three days’ notice.
Can a Patient Advocate Help With Medical Bills?
Yes.
A patient advocate can help a patient navigate the healthcare system and understand available resources.
According to CMS, patient advocates may help patients:
- Understand medical bills
- Apply for financial assistance
- Access medical records
- Communicate with healthcare providers
- Navigate healthcare resources
Many hospitals have patient advocates or patient representatives. CMS also identifies the Patient Advocate Foundation as a nonprofit organization that helps people with chronic or life-threatening illnesses navigate and pay for care.
If your medical bills are complicated, ask the hospital whether a patient advocate is available.
Can Nonprofit Organizations Help With Medical Bills?
Some nonprofit organizations provide financial or practical assistance to people dealing with serious illnesses.
Depending on the organization and eligibility requirements, assistance may include:
- Medical expenses
- Prescription medications
- Transportation
- Lodging
- Insurance navigation
- Food assistance
- Other treatment-related expenses
USA.gov also recommends contacting pharmaceutical companies about possible low-cost options, discounts or assistance for certain prescription medications.
Always verify that an organization is legitimate before providing personal information or paying fees.
Should I Use a Credit Card to Pay Medical Bills?
A credit card can be used to pay medical expenses when the provider accepts it, but it may not always be the most affordable option.
The CFPB warns that medical credit cards and financing plans can have significant costs, particularly when promotional periods end or deferred-interest conditions apply. Some medical financing products can carry interest rates above 25%.
Before putting a large medical bill on a credit card, compare it with:
- Hospital financial assistance
- Charity care
- An interest-free payment plan
- A negotiated medical bill
- Government assistance
- Nonprofit assistance
- Other financing options
The CFPB recommends investigating financial assistance and insurance coverage before agreeing to a medical credit card or payment plan.
Can Medical Debt Affect My Credit?
Medical debt can have consequences if it remains unpaid and enters collections, although credit-reporting rules and protections can vary.
The CFPB advises consumers to make sure a medical bill is accurate and to understand their rights regarding debt collection and credit reporting.
If you receive a collection notice for a bill you believe is inaccurate, keep the documentation and investigate the appropriate dispute process.
What If I Have a Serious Illness Such as Mesothelioma?
Patients with serious illnesses may face a combination of medical expenses and reduced income.
For someone diagnosed with mesothelioma, potential expenses can include:
- Specialist appointments
- Diagnostic testing
- Surgery
- Chemotherapy
- Prescription medications
- Hospitalization
- Transportation
- Long-term treatment
- Supportive care
In addition to standard medical assistance programs, some mesothelioma patients may have other potential sources of financial support depending on their circumstances.
These can include:
- Health insurance
- Hospital financial assistance
- Disability benefits
- Veterans benefits for eligible veterans
- Nonprofit assistance
- Asbestos trust fund claims
- Potential asbestos-related legal claims
Eligibility varies, and not every patient will qualify for every source of assistance.
Can Veterans Get Help With Medical Bills?
Veterans may have additional resources available through the Department of Veterans Affairs.
The CFPB notes that veterans experiencing financial hardship may have options involving repayment plans, copayment exemptions, debt relief and other forms of assistance depending on their circumstances.
Veterans should contact the VA or an appropriate VA representative to determine which programs may apply.
What If My Medical Bill Is Already in Collections?
Do not automatically assume that you have no options.
If you are applying for financial assistance, CMS recommends informing the debt collector that you are seeking financial help and asking whether collection activity can be paused while the application is being reviewed.
You should also verify that the debt is accurate.
Keep copies of:
- Collection letters
- Medical bills
- Insurance statements
- Financial assistance applications
- Emails
- Letters
- Notes from telephone calls
If a medical debt has been incorrectly reported to a credit reporting company, you may have dispute rights.
What Is the No Surprises Act?
The No Surprises Act provides federal protections against certain unexpected out-of-network medical bills.
According to CMS, the law generally applies to most types of health insurance and protects patients from certain surprise bills involving emergency services, certain non-emergency services connected with in-network facilities and air ambulance services.
The law does not apply to every medical bill or every healthcare service.
Patients who believe the law may apply to their situation can contact the CMS No Surprises Help Desk at:
1-800-985-3059
CMS says the Help Desk is available seven days a week and provides language assistance in more than 350 languages.
What Is the Best Way to Get Help With Medical Bills?
There is no single program that works for everyone.
A practical approach is to work through the available options systematically.
Step 1: Check the bill
Make sure you were charged for services you actually received.
Step 2: Review your insurance
Compare the medical bill with your Explanation of Benefits.
Step 3: Contact the provider
Ask for an explanation of any charges you do not understand.
Step 4: Ask for financial assistance
Request the hospital’s financial assistance or charity care policy.
Step 5: Ask for a payment plan
Find out whether the provider offers an interest-free arrangement.
Step 6: Check government programs
Review Medicaid, Medicare, ACA Marketplace and other programs for which you may qualify.
Step 7: Contact a patient advocate
Ask whether your hospital has someone who can help with medical billing and financial assistance.
Step 8: Investigate nonprofit assistance
Look for legitimate organizations that assist patients with medical expenses.
Step 9: Consider financing carefully
Only after reviewing other options should you consider credit cards, medical financing or personal loans.
Questions to Ask the Hospital Billing Department
When you call the hospital, consider asking:
“Do you have a financial assistance program?”
“Do I qualify for charity care?”
“Can my medical bill be reduced?”
“Do you offer an interest-free payment plan?”
“What documents do I need to apply?”
“What is the deadline for submitting an application?”
“Can I apply for financial assistance if my bill has already gone to collections?”
“Is there a patient advocate who can help me?”
Writing down the representative’s name, the date of the conversation and any reference number can make future communication easier. CMS recommends keeping track of these details when dealing with billing issues.
Final Thoughts
Medical bills can be difficult to manage, but patients may have more options than simply paying the full amount immediately or putting the balance on a credit card.
Start by checking the bill, reviewing insurance coverage and contacting the healthcare provider. Ask about financial assistance, charity care and payment plans. Then investigate government programs, patient advocacy organizations and nonprofit assistance that may apply to your circumstances.
For patients dealing with serious illnesses such as mesothelioma, the financial challenges can extend beyond the hospital bill itself. Treatment-related expenses, reduced income and long-term care can make it especially important to understand all available resources.
The most important step is to ask questions before taking on new debt. Financial assistance and payment options can vary considerably by hospital, state, insurance coverage and individual circumstances.
This article provides general educational information about medical bills in the United States. It is not legal, medical, tax or financial advice, and eligibility for any program should be confirmed with the appropriate government agency, healthcare provider or qualified professional.
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