How to Handle a Medical Bill You Cannot Pay in 6 Steps
Handle a medical bill in 6 steps: check the itemized bill and insurance, dispute in writing, negotiate, ask about charity care, set a plan, per CFPB.
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A medical bill arrives for an amount you cannot pay in full, and the due date adds pressure. Before you pay anything, a short sequence of checks can change what you actually owe. This guide follows the order the Consumer Financial Protection Bureau (CFPB) recommends: check the bill, check your insurance, dispute, negotiate, seek assistance, then set a plan.
Summary
- Review the bill carefully, and ask for an itemized bill for complicated procedures.
- Make sure your provider has your correct, up-to-date insurance information.
- Dispute bills you do not owe in writing, with copies of your documents.
- Negotiate the amount, and ask about financial assistance programs.
- Agree a payment plan with the provider instead of putting the bill on a credit card.
| Step | What you check | What it may give you |
|---|---|---|
| Itemized bill | Each service and date | Errors or unfamiliar providers found |
| Insurance | Correct info on file and coverage | Bills your insurance should have covered |
| Negotiation or assistance | Up-front payment, insured rate, charity care | A lower balance or a no-interest plan |
What to see in the table: the first rows verify the bill, and the last row lowers what you pay. Do not skip the verification rows, because a lower payment on a wrong bill still leaves the error in place.
Step 1: Check the itemization
Review medical bills carefully. If you do not recognize the provider, check the date of service to see if you had medical treatment on that day. For more complicated procedures, ask for an itemized bill from the provider so you can check how much you were charged for each service.
Some providers who bill you directly may have been associated with a hospital where you were treated, so you may not have known you were receiving services from them at the time. The CFPB's separate consumer guidance adds one more check: look for duplicate charges, such as the same service billed twice.
Step 2: Check your insurance
You should know what your insurance covers and what it does not, but first your insurance information needs to be up to date and accurate. A small mix-up can lead to big bills for expenses that your insurance should have covered.
Confirm your provider has your correct insurance information on file before accepting the balance. If the bill shows a service your plan covers, ask the provider or the insurer why it was billed to you.
Step 3: Get documentation and dispute quickly
Prepare an organized record of all bills. If you need to dispute a bill, send a written notice to the provider and include a copy of all relevant documents, such as records from doctors' offices or credit card statements. Do not send original documents.
Act quickly to resolve or dispute the medical bills you receive. If you have verified that you owe the bill, try to resolve it right away, and verify whether an insurer is paying for all or part of it. If you do not owe the bill, act quickly to dispute it. If you delay and the bill ends up in collections, it can have a significant impact on your credit score.
Step 4: Negotiate the bill
Hospitals may negotiate the amount of the bill with you. The tab may be reduced if you pay the whole amount up front. You can also try asking for the rate that people who have insurance get.
The hospital might also offer a plan that enables you to pay off the debt in installments at no interest. The CFPB's advice is short: it does not hurt to ask.
Step 5: Ask about financial assistance
Many hospitals have financial assistance programs, which may be called charity care, if you are unable to pay your bill. Ask the hospital's billing office whether such a program exists and how to apply.
Check the deadlines, which can vary, and gather the documents the application asks for before the deadline passes. If you qualify, the program may reduce the balance.
Step 6: Set a payment plan, and keep it off your credit card
Do not put medical bills on your credit card if you cannot pay them off immediately. If you cannot immediately pay off a high debt on your credit card bill, you will be charged high interest, and it will look like regular debt to other creditors. The CFPB's consumer guidance also warns that putting a bill on a credit card or a medical credit card can cost you the ability to negotiate the debt.
Instead, ask your medical provider for a payment plan with little or no interest. A simple way to picture the plan: if a balance is split into 12 equal monthly installments, each installment is one twelfth of the balance. This example assumes equal installments and no interest, so ask the provider whether interest applies before you agree, and get the agreed terms in writing.
Choosing order
- Verify the bill and your insurance information first, before paying anything.
- Dispute errors in writing, with copies of your supporting documents.
- Negotiate the amount, ask about financial assistance, then agree a written payment plan.
Before you submit
- Check that every bill in your file shows the provider, the date of service, and the amount charged.
- Keep copies of every letter and application, and never send original documents.
- Note each program deadline, since financial assistance deadlines vary.
- Keep your itemized bills, insurance letters, and payment plan notes together in one folder, paper or digital, so you can find them when the provider calls.
This article is for general information, not financial advice.