Dear Addy: Overwhelming Medical Debt

Dear Addy,

A friend of mine recently had a dangerous health scare. Luckily, after half a year of treatment they pulled through. The only issue is that they now have a great deal of medical debt accumulated. What advice can I give them and what advice you have for avoiding that situation in the first place?


(Dealing with and) Dodging Debt

Dear Dodging Debt,

First, I’m glad to hear your friend is doing better! I’m sorry to hear about the medical debt though. Let your friend know they are far from being the only one, around 100 million Americans have some amount of health care debt, 41% being adults. It’s sad but most people going through health issues are left to navigate this overly complicated health care system we currently have. Even people with health insurance plans can be left with debt after a serious medical issue. The biggest challenge is for people who don’t have insurance at all or are underinsured. They could be stuck with huge out of pocket charges from not being insured, coinsurance, or high deductibles. It’s not all doom and gloom though, here’s some helpful information about dealing with medical debt and ways to avoid it in the first place. It all starts by knowing the ins and outs of various policies related to your medical coverage. These include understanding your insurance coverage, a hospital’s financial assistance program, and your state’s consumer protection laws.   

Before You Receive Care:

  • Do your research or find someone that can help you understand the plans available to you, then get the maximum coverage you can actually afford. Sign up for Medicare or Medicaid if you’re eligible for it and can’t afford other insurance plans.
  • Make sure you understand your coverage, deductibles, coinsurance, and copays. Call your insurer if you have any questions like potential out of pocket expenses.
  • Never forget that you can’t make changes to your policy unless its during open enrollment in the fall/winter or qualifying life event (QLE) that allows for a special enrollment period.
  • Make sure all the aspects of your care are covered, by checking that all your healthcare providers and procedures are in-network, ask what your copays are going to be, and if all preauthorization’s are in place.
  • If you’re uninsured, always ask what your cost estimate is going to be ahead of time.
  • If you can’t afford your treatment most hospitals have a financial assistance, sometimes referred to as “charity care”. Every hospital has its own eligibility conditions, luckily organizations like Dollar For can help you find out whether you are eligible for assistance or not.

During and After Treatment:

  • Always ask for the line items cost to every service, treatment, and prescription received and will received.
  • The No Surprise Act protects individuals from surprise bills for emergency services and some non-emergency services. If certain providers aren’t in your network and you receive services from them, but that wasn’t disclosed to you prior; than you can probably dispute that charge.
  • Always check for double billing.
  • When negotiating medical costs, its best to deal with the hospital directly. Especially if you know you won’t be capable of paying the bill. This is done through the hospital administration or billing department.
  • Make sure that essentials like shelter and food bills are paid first, over medical bills. Lenders and financial institutions handle medical debt differently than other debt like credit card or car loan debt. This is because people choose to buy these items through credit, but no one chooses to get sick or injured.
  • DON’T EVER SIGN UP FOR CREDIT CARDS OFFERED AT DENTISTS, HOSPITALS, OR DOCTORS’ OFFICEES. This is because once you do that it disguises your medical debt as regular consumer debt, making much more likely to hurt your credit score.
  • If all else fails, it’s important to contact free legal aid services for guidance and assistance.

I hope this information helps you and your friend! Remember to never give up advocating for your financial rights. There is help out there, so keep in mind that you are not alone!



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HFA frequently receives questions from the bleeding disorders community related to advocacy issues. The questions often impact the entire community. In an effort to reach the largest audience possible with our responses to these widely applicable questions, HFA developed “Dear Addy.” Questions submitted to this column are edited in order to protect privacy and should be considered educational only, not individual guidance.