Can I Protect Myself from Surprise Medical Bills?

Posted on December 27, 2017 at 12:00pm by

Many people in the US continue to be hit with medical bills that were larger than what they were expecting. There are cases where insured hospital patients are surprised by medical bills in the thousands of dollars.

Surprise medical bills are most likely to occur when someone is billed for the full amount by an out-of-network doctor or specialist. However, unnecessary tests or procedures can also catch you off guard. There are ways to fight and prevent unaffordable medical bills. While the following four tips may not be an option during an emergency, they could help you save money for a planned procedure or for other basic services.

  1. Check your coverage: You could make sure you are covered by insurance before receiving care at a specific hospital or clinic. Most health care centers will be able to tell you right away whether you are covered once you provide them with your insurance card. However, doctors, nurses or other specialists working at these facilities may not be covered. You could try asking to only be treated by health care providers covered by your insurance. Referrals are another cause of surprise medical bills. If your regular doctor refers you to a specialist or for a specific service, you should inquire about coverage beforehand.
  2. Ask about whether procedures or services are necessary: Some services or procedures may be prohibitively expensive. You could ask your health care provider about the necessity of these services or if there are less expensive options that are equally effective. In addition, you could ask your insurer beforehand about the cost of alternative procedures or services.
  3. Fight the bill: Medical bills may contain mistakes. If you received an unexpectedly large bill, you could request an itemized bill to review the charges. Look for duplicate charges or services you never received. In addition, your insurer might be willing to pay a portion of any out-of-network expenses. Some hospitals also have charitable services that partially or completely pay for medical bills. You should inquire about these options.
  4. Use a FQHC: Federally qualified health centers (FQHC) are a great way to save money on basic medical services if you have low income. These are centers that use sliding scale fees based on your ability to pay. We have published a guide on FQHCs and how to find one in Kansas City. However, certain clinics and hospitals that are not FQHCs may also offer payment assistance programs. You could inquire about which programs are available.

Unfortunately, there is very little you can do to avoid surprise bills during an emergency. You will likely not have a say in which hospital you want to go to if you are taken there by an ambulance. Despite this shortcoming, many hospitals or health care providers will negotiate with you on payments. They would rather get something than nothing. Insurance providers may also be willing to pay for more once you make an inquiry.

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