AARP: How to Pay Off Medical Debt


August 8, 2019

by Walecia Konrad

You’ve tried everything. You’ve negotiated with your doctor or hospital. You’ve checked and double-checked your paperwork to correct any billing errors. You’ve jumped through hoops to file appeals with your insurance company. And still, you’re looking at a huge medical bill that needs to be paid.

You’re not alone. A poll by Gallup and West Health, a nonprofit focused on lowering health care costs and improving care for seniors, found that Americans borrowed an estimated $88 billion to cover health care costs in 2018.

It’s important to understand that medical debt is different from regular debt. Government and credit-reporting rules regarding medical debt may affect the way you handle repayment, and there are some tools specially tailored to help with health care bills. Here are some tips, and the pros and cons, for several approaches to retiring medical debt.

Charity care

Most hospitals allow patients to apply for in-house financial assistance, sometimes called charity care, so ask what kind of help is available. Nonprofit hospitals are required by law to have written financial assistance policies and to inform patients that help may be available. Some for-profit hospitals have charity care programs that mirror those at nonprofits.

Discounts are typically based on income. For example, MedStar Health, a nonprofit system that operates 10 hospitals in Maryland and Washington, D.C., offers free, medically necessary care for uninsured patients with incomes up to twice the federal poverty level and discounted treatment for uninsured patients who earn two to four times the poverty level.

Don’t give up if you don’t meet the written income or insurance guidelines. Hospitals have considerable leeway to determine who gets charity care, says Jennifer Bosco, a staff attorney for the National Consumer Law Center. Some will reduce your debt if you can demonstrate financial hardship — for example, if your medical debt exceeds a quarter of your household income.

An important plus: You can apply for financial assistance long after you are billed (the federal rules governing nonprofit hospitals allow up to eight months). Even if a bill has gone to collections, you can still apply for charity care.

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