Help Paying Your Bills

01.23.2011Wall Street Journal


A growing number of people are facing significant medical bills because they’re uninsured or underinsured. Others have signed up for plans with high deductibles that they can’t afford to meet.

But there are ways to tackle these bills, and in some cases lower them, without damaging your credit. Hospitals, state agencies, charities and other groups often provide assistance. And many medical providers are willing to discount and delay payments.

“People are often in debt due to these bills,” says Cheryl Fish−Parcham, deputy director of health policy at Families USA, a nonprofit health−care advocacy group.

The first step is to try to renegotiate what you owe. Many hospitals offer free or low−cost care to uninsured and low−income patients who can’t afford their medical costs, even after the care has been provided. In many cases, you’ll need to show proof of income, such as recent pay stubs or tax returns.

Some hospitals are obligated to provide financial assistance because they are Hill−Burton facilities, which means they’ve received government grants or loans for construction or modernization projects in exchange for providing some charity care. Eligibility is based on income and patients need to apply at a hospital’s admissions or business office. Patients can apply even if treatment has already been rendered and they’ve been billed.

Also, hospitals typically will help some patients −− low−income children, pregnant women, the elderly and the disabled −− apply for Medicaid to see if they are eligible for coverage for care and treatment that has already taken place. Medicaid will cover expenses for eligible patients going back three months from the month when they apply for Medicaid, according to the Centers for Medicare and Medicaid Services. Many doctors and clinics also have programs for low−income patients, but people often don’t know to ask.

Even if you don’t qualify for a program, it doesn’t hurt to contact a physician or hospital and explain your financial hardship. A doctor may agree to a reduced payment or allow you to stretch out payments over an extended period. It’s important to be proactive and show a willingness to pay your debt. Don’t wait for the bill to go to a collection agency.

“There is room often to negotiate,” says Alwyn Cassil, a spokeswoman for the Center for Studying Health System Change in Washington, D.C.

Some nonprofits assist patients with medical bills for specific conditions. For example, the HealthWell Foundation ( offers grants to underinsured individuals with limited incomes to help cover the medication costs of certain conditions, such as breast and colorectal cancer. The Patient Access Network Foundation ( offers grants to help cover out−of−pocket costs for medications for various cancers and some other diseases.

Ms. Fish−Parcham cautions consumers about incurring other debt, such as using a credit card or taking out a home−equity loan, to pay off medical bills.

For one thing, the interest rate on a credit card will probably be higher than what you might be charged on a payment plan from a doctor or hospital.

What’s more, “if you take a second mortgage and then can’t make the monthly payments, you risk losing your home,” she says, “which is usually a far more serious problem than being in debt to the medical provider.”