A recent poll found that more than 40 percent of Americans have health-care debt. Health-care debt is one of the leading causes of personal bankruptcy. Adding to the problem is medical inflation, which rose almost 25 percent in the past year.

Even if you are insured, you have a good chance of running up health-care debt. For example, many people opt for extremely high deductibles (the amount you pay out of pocket before your health insurance kicks in) to get lower monthly premiums. I regularly hear from people who have $10,000 or higher annual deductibles. That’s fine if you think you will not be running up a significant medical tab that year, but should the unexpected happen, and you or a family member needs hospitalization or expensive outpatient surgery, will you be able to pay that deductible?  Many cannot.

Other ways medical debt accrues include denial of an insurance claim or reduced insurance coverage because you knowingly, or even unknowingly, went out of your insurance plan’s network of providers. And you might even accrue debt because a medical provider misbilled you for services you never received. 

To help you avoid health-care debt, or to help you reduce it, here are some steps you can take:

Fully understand your policy. No matter how well insured you think you are, it’s important that you regularly review your health insurance policies. Most make changes from year to year, some of them significant, such as increasing your deductible or co-pay. Other changes may reduce coverage for certain procedures or drop certain medications from their list of covered drugs. It is worth the time to review your insurance each year at renewal time. And don’t hesitate to contact the insurer’s customer service department to help you wade through the changes.

Ask questions before saying yes. Before agreeing to any procedure or treatment, contact your insurer to make sure it is covered. Do not accept your doctor’s assurance that what is proposed will be covered. He or she usually does not know the full scope of your insurance policy and might be wrong. Also, make sure that both the doctor and facility you will be using are part of your insurer’s network.

Negotiate. If you already have health-care debt, or you know you will have difficulty paying your share of an upcoming medical bill, do not hesitate to negotiate with your doctor, hospital, or other service provider. All medical costs are negotiable. For example, most hospitals will help you pay off your bill by setting up a monthly payment schedule you can afford. Physicians will do the same. You should also ask the providers if they participate in any programs that help patients who cannot pay their bills. Most hospitals have their own charity programs that you may qualify for. Many doctors will waive certain costs to help you out. Don’t be afraid to negotiate.

Check the bill. Up to 80 percent of medical bills have an error in them. This is especially the case with hospital bills. Often hospitals have a checklist of services routinely provided for a given procedure, such as a births, coronary bypass, or gallbladder removal. Unless the doctor or nurse unchecks something you did not have, you might be charged for it. For example, when our daughter was born, my wife gave birth in the labor room, but we were charged $1,000 for the delivery room. I insisted it be removed and the charge was reduced. So, look over all your bills and hold the provider accountable for any errors.

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