Q: I received a medical bill that it is very expensive. I cannot afford to pay this huge bill. What should I do?

A: When you receive a medical bill that looks larger then expected it can feel very stressful and upsetting. Right away you are wondering how you will pay this bill and you may even feel angry that it was such a surprise. Take a moment to breath and relax and know there are steps to take to try and help this situation.

Make sure this is, in fact, an actual bill from the provider and not a Medicare Explanation of Benefit (EOB) or a Medicare Summary Notice (MSN). These statement notices can sometimes appear like a bill and cause alarm. The EOB or MSN is just an overview from Medicare of the total charges and what the insurance is expected to cover. You will receive a separate bill from your provider showing what you owe.

The first thing to do is check that they billed your correct insurance. Sometimes they do not bill your supplement, or perhaps had an old insurance on record. Call if needed to verify that this bill has gone through the appropriate insurance process first.

Next, you want to look to see if the service(s) that have been charged were in fact the ones that were provided. Sometimes, services are billed incorrectly.

Contact the billing department. You can find their phone number on the bill. You may want to prepare a few questions to ask: Are you able to provide me some insight on your billing process? I see that I have been charged for X and wondering if my insurance has been billed their portion. Are you able to provide the amount my insurance is being billed?

Once you have confirmed that this is an accurate bill of your portion of the costs then you move forward. The next step is to ask the provider’s billing department if they can reduce the bill or create a payment plan that will work for you. Explain that paying this bill is a hardship for you due to your finances.

Often the provider will work you on the bill. Some providers may even have a financial hardship form that you can fill out to reduce or eliminate the bill. At the least they should be able to work out an appropriate payment plan.

If you need additional guidance in navigating your billing issue, contact the Health Insurance Counseling and Advocacy Program (HICAP). HICAP may be able to assist you if you feel the bill is inaccurate or you were billed for charges you did not accrue. They can explain the process to appeal a medical bill with Medicare. Reach out for help and do not ignore the bill. If you simply do not pay, then it may go to a collection agency. You want to avoid this because it can affect your credit and then you will not be able to get it reduced.

HICAP can also help you in reviewing your current insurance plan and research if there is a better and more cost savings plan for you. It is currently the Medicare Open Enrollment Period (October 15th through December 7th), so this is the best time to examine your options for next year. Call for an appointment at 805-477-7310.

Most importantly, take a proactive approach in understanding your health care and insurance benefits. Do not let fear of medical bills prevent you from receiving the care you need. Take advantage of all the preventative care covered so that you can try and avoid other medical needs. Check to make sure you are seeing providers that in the network of your insurance plan. However, when your health is in question, do what you need to get the treatment required. Your health should always be the priority.

Martha Shapiro can be reached at Senior Concerns at 805-497-0189 or by email at mshapiro@seniorconcerns.org


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