Q&A: Overwhelming Medical Bills

by Kelly · 10 comments

in Etc,Tell Us Tuesday

Edited to add: The suggestions, ideas and support that people have left in the comments are amazing- I’m so proud of the community here!

Ellen left this comment on the envelope system post.

I thought it was so important that I turned it into a post of its own- I just know you guys will have good suggestions for her!

I struggle to pay all our bills which are mostly medical.  The costs keep going up as we are dealing with a lifetime medical need.  Right now I am paying $15 to each medical bill.  Last month one hospital sent us to collections and another Dr. is threatening to with only about $33 left on that bill.  Some weeks we are left with $45 for groceries and life after the mortgage, gasoline for my husband’s commute, car payment on a car that does not run; we owe about $350. more on it) and approximately $ 2,000 on a debit bill which added up several years ago while we were struggling before our larger home was sold.  I ride my bike which was a gift to me, but I wonder if anyone has suggestions how to get through as I don’t see medical bills listed on the topics above.  thanks for any ideas.

Well, the first thing that I would say, is that the beauty of the envelope system is that you can add or subtract envelopes as needed, so it’s really very flexible.

You’ve probably tried as hard as you can to cut all your expenses, but, if you’re not already doing so, keeping track of what you’re spending will help see where your money really is going. I find that a kind of ‘audit’ where I write down every thing that I spend to the penny, shows me if there are any leaks in my wallet… and there usually are a few!

Another suggestion I would have is to try to increase your income. I know it’s not easy to find extra jobs- I’m kind of sick of personal finance experts telling people to set up their own lawn-mowing business, and so on. But on the other hand, you could try to think of ways of earning income that don’t necessarily involve doing more work. For example, could you rent a room in your house to a student, or swap a friend’s garden produce for time spent weeding?

Finally, I know that a lot of people are opposed to charity, but I think that such systems exist for when people need them. Afterward, when you’re on the other side, you can help others, but it seems like right now you need help the most. So, is there a program you can lean on- maybe at your church, or a local food bank? You didn’t say where you live, but I think that many states offer medical bill relief plans.

Readers- any other suggestions for Ellen?


1 Miguel de Luis Espinosa June 26, 2009

Except moving to a country with Universal Health Coverage like many (read not all) nations around Europe – I really don’t know, perhaps taking as healthy as possible lifestyle would help to alleviate costs. You probably need to listen to your doctors and avoid debt as much as possible and cut every expense you can.
In other words focus on what you can do.

2 Nancy June 26, 2009

As Kelly mentioned I would suggest looking into local community groups that offer assistance for such needs. In our community there is a group that does this and they are wonderful. It’s there to help those in need. Please don’t be embarassed by approaching a group such as this; this is why they exist. Also some hospitals have similar resources available.
.-= Nancy´s last blog ..Life is Full =-.

3 Sherry June 26, 2009

I am unsure of the nature of “how” the health bills were accured or “what” kind of facilities/individuals are involved. This is key to how you approach the debt. Most MD’s will not “negotiate” down your bill however, almost every hospital or large facility will reduce your total amount due & will support a payment system. The key to this process is COMMUNICATION at the BEGINING of the payment process. I realize that this is not foremost on one’s mind when a medical illness or catastrophe has occurred. However, it is absolutely necessary for anyone to handle these situations in the same manner or urgency you get your medical care. Moving to another country will a “univeral” health systems is NOT going to resolve your current debt.

For your current situation, I would immediately make an appointment (s) with those involved be it the hospital accounting MANAGER (not the front line staff), the MD office MANAGER, etc. You want to meet with the individual(s) who has the authority to act on your account i.e. “write off the balance” OR work with you on a payment plan. ANYONE, HOSPITAL OR OTHERWISE, WILL WORK WITH YOU IF YOU ARE PAYING REGULAR MONTYLY PAYMENTS, EVEN IF IT IS $5/MONTH!! Failure to make a $5 payment will violate your “contract” with them & will cause them to sue you for the FULL unpaid amount.

I am an RN (for almost 20 years) & have worked most of my career in a hospital but also have always worked part time (side hustle) in a MD’s office. I have worked with office managers to help with patients who are struggling financially to find asisstance for RX, bills, outpatient services or home health. If you are diligent, you can do this, but you must keep meticulous records of your meetings, conversations & understandings/agreements.

I recently worked to help a friend who had over $45K in medical bills. I will tell you the following:

1. She had NOT EVER communicated with those billing her until her bills went to collection.
2. She claimed to be paying on every bill, every month, but upon further review of her cancelled checks, she was actually paying every 60-90 days. She was so overwhelmed with “life” that she had lost track of time.
3. She (and her family) had cell phones, cable, internet. None are necessities in this life. (Perhaps a cell if using as an only phone, but all the bells & whistles are NOT necessary.)
4. They regularly drank soda & smoked. I know, both are personal choices but major money drainers, not to mention bad for your health.

I helped her identify $$ in her income (about $300) which was could be applied against her bills. We also set up appts. with the various healthcare providers to work at coming up with payment plans for now & in the future (her husband is chronically ill & future hospital stays are expected).

I know it can seem overwhelming & it is, but it can be done. If your situation is going to be ongoing, then I would pursue government or community assistance for future. However, receiving assistance from them now will no resolve past debt. There are community agencies that will help with medical bills but usually it is before an occurrance (like a transplant, et). Again, meeting & communicating is the key to resolving your debt.

4 Been There June 26, 2009

I second Sherry’s advice re: communicating with the hospital. Yes, it’s embarrassing. Yes, you may feel judged. TImes are hard, though, and we all need a little help now and then. I had a very positive experience after discussing with the hospital billing manager the fact that as a single parent of a newborn, my budget didn’t allow for me to pay off the large hospital balance. They asked for my salary, ran some calculations, and wrote off 40+% of the bill. I was told that the hospital gets tax benefits for this, and that many eligible people don’t ask for help, perhaps because they are embarrassed. I say, take the help and try to pay it forward somehow when you are able. Good luck!

5 Lisa June 26, 2009

This one hits home for me, and a few things stand out. First she should apply for gap coverage through medicaid. If there is a serious illness this may be available. It’s not charity-they pay for it every paycheck! Also, I’m not sure if it’s just co-pays owed, which means the providers already got the lion’s share of the payment. Why pay for a long commute? Get work closer to home. Why have a car that doesn’t work? I don’t get this one. And age makes a difference, maybe medicare is available. She mentioned having two homes: don’t do this in a down market! Paying two mortgages probably tanked them. Of course sending a letter to all payees is essential. Discounts for prescriptions are available through alumi associations, AAA, AARP (at 49!) and more.

6 Tom June 26, 2009

I think Sherry hits on all the points for addressing the medical bills(great post).Try not to get discouraged.

7 Sherry June 26, 2009

Lisa makes a great point (job change), however, before you considering changing jobs, review your medical insurance coverage. If you change jobs (which implies a medical insurance change) & you have a pre-existing condition, then your NEW insurance may not cover that part of your health care needs for 1 year. Just an FYI.

Great comment on gap coverage. Didn’t think about that! 🙂

8 Marj June 27, 2009

When I became disabled it was suggested, by a wonderful nurse, to write a letter of hardship to the people you owe money to.
This letter should contain the amount of money coming in each month, then list each bill you have and the amount you pay each month. Make copies and send to each company with your next payment.
Be nice about explaining there are just not enough dollars to go around. Our bills were medical also. Some companies are wonderful……..the ambulance cancelled the entire bill. Some companies are not as nice.
I wish you luck and may Jesus help keep you strong.

9 Abigail June 28, 2009

Well, most of the major points have been hit, but let me ramble a bit anyway.

I’ve used the charity programs in hospitals before. The biggest point is to not let them deter you. For example, my husband was having breathing problems so we ended up in the ER. The bill was nearly $400. Our deductible meant it wasn’t covered. When I called the financial aid department, they told me that since he had insurance, they probably wouldn’t cover it. I asked for the financial aid form anyway.

After we filled out the form, I wrote a cover letter. I explained our situation — husband’s health problems keep him out work, I have a disability and can’t work much, and hubby’s insurance is $502 a month out of our $3245 income. I then pointed out that there were items not listed on the form. Like the fact that the only stuff that soothes my husband’s severe eczema is a Body Shop line of products. And they’re pricey, but we have to use them to keep him at all sane. That we were trying our hardest to be diligent about bills and paying off debt, but with a low income and lots of expenses, it was simply hard to make much progress.

The bill was reduced to $118. Still not perfect, but a heck of a lot better than $400.

So I guess my point is that, in bureaucracy, if you get a “no” then you’re probably not asking the right question. Especially when it comes to financial help. Try rephrasing it. Try going up the food chain to a supervisor. (Sometimes the front-line people say no because they cannot, in fact, do it. But someone higher up can.)

The Medicaid is a good idea. It will help cover any coverage gap in Medicare (if you/your spouse has it). If not, it should cover most of your bills from here on out. If you make too much for Medicaid… I hate to advise this but… Find out what the limit is. Do the math of what if you didn’t have any co-pays on meds or doctors. There’s a decent chance it would be cheaper for you to earn less money and get Medicaid.

Also, contact the doctor who is threatening collections. It’s an automatic letter that prints up after a certain period of time. The doctor doesn’t send it, his staff does. Ask the doctor to call you. Explain your situation. Tell him that you WILL get him the money. Remind him that taking you to collections for $33 will mean he gets almost no money and the collections agency will, indeed, get the full amount.

The Catholic Archdiocese tends to have agencies in various cities. It also tends to be one of the bigger agencies for helping people in times of need. You don’t have to be Catholic. You just have to be in need. Which it sounds like you are.

I don’t know the lifetime medical condition, of course, so I can’t speak authoritatively, but as someone with a chronic health problem (married to another person with chronic health problems) I am guessing more work is not really an option. Though the bartering idea isn’t a bad one. Overall, I’m betting you don’t have much energy to spare, especially being so stressed out about bills.

But the idea to sell the non-functioning car is a good one. You should be able to get at least $100 for it. Probably more. If you only owe $350, that’s a lot closer to being finished with that bill. And you may want to double-check: Are you absolutely sure you took the second car off your insurance? Otherwise you’re paying extra.

Also, find local food banks. They are a godsend. They’re not fun. The first few times can be excruciating for stubborn, proud folks. (I really hated going, but I really appreciated the food.) The fact is that, in good times, we give to these places. In bad times, we feel weird about taking part in them. Logically, that makes no sense. And remember that, if times get better, you can repay them with donations or time. (Also, if you do have energy, I’d consider volunteering at a food bank. You’ll get dibs on some of the better stuff and it helps some folks feel better about using the service.)

As for government programs, you pay taxes. You pay for these programs. If you need them, use them. And if you’re told you can’t use them, keep asking questions until you know exactly what the most you can make is and any other conditions surrounding them. Then figure out how to make yourself fit those guidelines.

Also, call your local utilities companies. Many have lower rates for people who are low-income. I suggest taking a good long look at those utilities, too. With low-income help on our landline, we pay only $9 a month. We took off long-distance, which we hardly use anyway, and that took off something like $15/month. At least here in Seattle, you can get free compact fluorescent (sp?) bulbs from the city. So check into that, as well. And find out if you can make dump runs to lower your trash collections cost. A friend with a truck might be willing to take you once a month.

Finally, I know it’s hard to consider, but you may want to think about putting your house up for sale. Rent is probably cheaper than what you’re paying for a mortgage. And if you can sell at any kind of profit, you will have money to pay off at least a few bills. I know most people dream of a home. It’s heart-wrenching to consider giving that up. But it sounds like you’re in the “desperate times call for desperate measures” state.
.-= Abigail´s last blog ..Sometimes, it’s just about making progress =-.

10 Monroe on a Budget June 28, 2009

If you live in the metro Detroit area, go to Julie’s List at http://julieslist.homestead.com/ She has an absolutely huge database of non-profit, private and government resources to help with all kinds of expenses, including medical.

If you live elsewhere in the U.S., call 211. In many communities across the U.S., this is a hotline like the 911 or 411 systems you are already used to for other purposes. But 211 focuses on linking people up to human services.

You also want to contact the social worker who is assigned to, or works at, your hospital. He or she will know about the resources that are available to local patients and can get you connected to those programs and services.

In the meantime, start getting your financial and identification documents in order. A lot of programs that are available to assist families in crisis do require paperwork or an application process so they can identify eligible families. You’ll want to have things ready such as photo ID, proof of residency, proof of military or veteran status if applicable, proof of income and / or unemployment status, your most recent tax records, and a list of all your other financial obligations.
.-= Monroe on a Budget´s last blog ..Get organized on groceries with my 8-week plan =-.

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