Even if you have health insurance, sickness plus bad luck---such as finding that your condition isn't covered---can cost you a fortune and leave you deep in debt. And medical expenses aren't like other expenditures. When you're having a heart attack, you don't have the luxury of deciding whether to get treatment or of shopping around for the cheapest doctor like you would for a new car. However, like other types of debt, medical debt can hang over your head for years and can ruin your credit score. If you find yourself in debt, know that you have rights.
Bills
You have the right to request a copy of all of your bills. It's not enough for the hospital to provide you with a total. It must give you a clear breakdown of all the costs. Go through the bill with a fine-tooth comb. Check for mistakes. These can be costly. Query anything that you're unsure about or that doesn't look right. You should never have to pay for treatments that you didn't actually receive. Hospitals rely on the fact that most people and insurance companies don't have the time to check every line of the bill. Take the time. It can save you a lot of money.
Insurance
Whether you have private health insurance, Medicare or Medicaid, make sure that your insurer has paid for everything it is obligated to pay for. Check your policy wording carefully. Call up the insurer and ask why certain treatments weren't covered. Get them to send you an "Explanation of Benefits." If you've been making your monthly payments, the insurer has to cover everything that's listed in the policy. If it turns down a claim, you have the right to appeal. Check your policy for the exact procedures. If the insurer still says no, you may be able to file an external appeal, or even take the company to court.
Negotiating Your Debt
You have the right to negotiate your debt. Contact the hospital directly and ask about setting up a payment plan. Most hospitals are happy to sit down with you and come up with a plan that you can afford. It's not in their interest to bankrupt you. In some cases, uninsured patients get charged more for the same procedure than insured patients. This is because insurance companies can negotiate a discount. If you genuinely cannot pay your bills, the hospital may reduce them to the same rate as it would charge an insurance company. If you do set up a payment plan, the federal Truth in Lending Act gives you the right to know the exact terms and conditions of the plan. Ask for it in writing.
Getting Help
Different states have different programs to help people out of medical debt. For example, most Connecticut hospitals are required to provide some free care to patients who cannot pay their bills. Some hospitals have "free bed funds," which use donations to cover the costs of some patients. Connecticut law also states that hospitals can't collect more than the actual cost of services from low-income uninsured patients who do not qualify for Medicaid. This effectively results in a discount for some poor patients. Check whether your state has a similar law.
Debt Collection Agencies
If you haven't managed to negotiate with the hospital and it has passed on your debt to a collection agency, you still have some rights. Under the federal Fair Debt Collection Practices Act, debt collectors cannot contact you before 8 a.m. or after 9 p.m. If you tell them not to call you at home or at work, they must comply. Make the request in writing so you have proof. Debt collectors are not allowed to harass or threaten you or make false claims about your debt.
If the collection agency reports your debt to a credit bureau, it is obligated under the Health Insurance Portability and Accountability Act to keep your medical history private. The Fair Credit Reporting Act requires debt collectors to be honest in reporting your debt. If you think they've lied or made a mistake, you can challenge it through the credit bureau.
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