Medical bills that may range from hundreds to thousands of dollars can be stressful and frightening. Debt, especially from events you can’t control, can create an even wider range of emotions.

It’s something my family and I know all too well. After a high risk pregnancy and a child whose first of a dozen surgeries happened when they were only a month old, we faced mounting medical debt.

Over the following years, surgeries, therapies, hospital admissions, and thousands of dollars in medical debt followed. I had many emotions, but for me, shame was a powerful one.

Even though we’d done nothing wrong, facing that level of debt was overwhelming and not something I dared discuss with anyone. But years later, I understand the truth — medical expenses happen. Even if you do everything “right,” you get sick, accidents happen, and costs — even after insurance — can mount quickly.

If you’re experiencing the stress of medical expenses and debt, you are not alone.

A 2019 review based on the 2015–2017 National Health Interview Survey found that 137.1 million adults reported financial hardship due to medical expenses in the past year. Of these 137.1 million adults, almost 47% of individuals ages 18 to 64 years old reported psychological difficulties. More than 28% of adults 65 years old and older reported psychological distress related to their medical expenses.

Illness, injury, and healthcare are a part of life, and for millions of people in the United States, that means medical debt. Here are things you can do to face these expenses, reduce what you owe, and stop these bills from being sent to collections.

While this is not financial or legal advice, read on to learn what I wish I’d known — what to do about medical bills and where to find help.

Here are seven things to try if you can’t pay your medical bills.

The first step is to collect all the medical bills you have received, and if you have insurance, collect all correspondence from your insurance company. If possible, keep them organized by service date and provider.

When medical bills begin to pile up, it’s easy to ignore them — stuff them in a drawer, toss them, or just decide to think about them later. Resist this temptation.

The most important thing you can do is remain engaged and active. If you can, be proactive and call the hospital, doctor’s office, or other service provider to discuss your bill. Yale University found that over 75% of people surveyed who contacted a medical service provider about a medical bill they couldn’t pay were able to negotiate the cost down.

You may have a window of opportunity to negotiate a lower rate or explain your situation to see if your care provider has allowances for it. Often, there is a time limit to challenge a bill or to ask for assistance.

That same Yale University survey found that 1 in 5 people found errors in their medical bills.

If you don’t receive one, request an itemized statement for all services billed to you. Carefully reviewing medical bills can help you catch any errors and may save you money.

You may have several bills for one medical encounter. For example, if you have surgery, even outpatient surgery, you may have separate bills for the costs of your surgeon and their staff, the clinic or hospital operating room, and other healthcare professionals such as anesthesiologists.

The Centers for Medicare & Medicaid Services (CMS) recommends these steps to Medicare recipients, but the advice is good for anyone reviewing their medical bills:

  • Get an itemized, detailed bill.
  • Get a copy of your medical records to compare to the bill.
  • If you used insurance to cover the costs, contact your insurance company and request your Explanation of Benefits (EOB), a form that explains what the insurance company paid and what you still owe to the provider for the services you received.
  • Be sure you were not billed twice for the same service.
  • Search online for the medical codes of the procedures and services you received and compare these codes to your bill. This process can be complicated because there are several types of medical codes:
    • ICD codes: These codes record medical diagnoses.
    • CTP codes: These codes record the procedures and services you received.
    • HCPCS codes: These codes cover procedures and services not included in the CTP codes.
  • Contact your state’s patient advocate program or a consumer assistance program to help you review and understand your bills, the coding, and charges.

You’ll need to confirm you received the services and items you are being billed for. Your medical records should help you determine this.

Speak with the business office at your healthcare professional’s office or the hospital, and ask them to clarify anything you don’t understand.

Dispute any errors you find with your service providers or your insurance company. Be aware that there may be time limits to challenge charges or insurance payments.

It’s important to notify service providers (healthcare professionals, clinics, and hospitals) and your insurance company, if appropriate, as soon as you find an error. You can call the billing department, but you may also need to put the dispute in writing.

It’s important to keep records of all calls and copies of all correspondence related to disputed medical bills.

Take care of you!

Coping with health challenges is stressful enough without having to face medical bills as well. Just when you need to be focused on getting better or caring for a loved one, you are collecting medical records and bills and wondering how they will all get paid.

Another lesson I wish I had learned when I was facing medical debt was to ask for help and prioritize my own self-care. Taking care of yourself is crucial and not an option.

Here are a few resources to help you find support:

Many hospitals offer programs to support individuals facing financial challenges. Sometimes called “charity care” or “charity assistance,” some hospitals can reduce your medical bills if you can prove that you meet their income requirements.

Nonprofit hospitals must offer financial assistance to maintain their tax-exempt status. Contact the hospital’s business office to see if you qualify.

Speak with the hospital patient advocate. You can usually find these staff members in the hospital’s billing department. If you have a hospital stay, you may have access to a social worker. These healthcare professionals can help you find resources and may be able to help you find assistance paying your hospital bill.

In the United States, there are laws that provide some protection to healthcare consumers. Start on your state’s Consumer Assistance Program website.

Here are the main rights you currently have (your state may have even more legal protections):

  • No Surprises Act: This law ensures that if you have private insurance, you will pay no more than the in-network rate if you are treated at out-of-network facilities or by out-of-network healthcare professionals without your consent. The law does not apply to emergency care. If this law is not honored, you can also file a complaint with CMS.
  • A good faith estimate: If you do not have private insurance, ask for an estimate of the costs of the care you expect to receive. You need to ask for the estimate at least 3 days prior to your expected date of service. If the bill is more than $400 over the expected amount, you have the right to dispute the bill.
  • The Fair Credit Reporting Act (Regulation V): This law prohibits creditors from accessing your medical information and using medical debt when considering a credit application. It also prevents creditors from adding medical debt under $500 to your credit report.

If you have a chronic condition or need long-term treatment, government programs like Medicare, Medicaid, or the Children’s Health Insurance Program (CHIP) may help with your medical expenses. If you are 65 years old or older, you qualify for Medicare, but you’ll need to enroll.

Eligibility for these programs is typically based on income, age, or both. You can apply for Medicare, Medicaid, and CHIP online or in person in your state.

While Medicare and most other programs won’t cover medical expenses you’ve already accrued, if you qualify, they will likely help with future medical costs, especially if you have a chronic health condition.

Organizations like the Patient Advocate Foundation and the HealthWell Foundation can help if you are facing medical debt. These organizations have experts on specific medical conditions and in healthcare fields who can help:

  • review medical bills for accuracy
  • dispute inaccurate bills
  • negotiate reduced costs
  • find other resources

If you don’t qualify for assistance, you may want to consider hiring an expert or company to help review, negotiate, or dispute medical expenses. Depending on the amount, this option may still save you money.

Medical billing advocates are trained professionals who help review, negotiate, and dispute medical bills. They are often employed by law firms, but some individuals and companies also provide their services to individuals.

Professional organizations like the Alliance of Claims Assistance Professionals (ACAP) can help you find an accredited medical billing advocate in your area.

What You Can Do Today

  • Collect all your medical bills and insurance Explanation of Benefits (EOB) forms.
  • Request a detailed, itemized bill from the hospital or the healthcare professional’s practice.
  • Request a copy of your medical records for the service or admission in question.
  • Ask to speak with the hospital patient advocate if you received services at a hospital.
  • Review the list of organizations that may be able to help you.

Having medical bills you can’t pay can be an overwhelming and stressful experience. Trying to recuperate or care for a family member while they recover can be all-consuming. The last thing you want to think about is all those medical bills arriving in the mail. But there are things you can do and people who are available to help.

Here are seven tips for finding help if you can’t pay your medical bills — steps to take, things you can do now, and resources that may be able to reduce some of your costs.