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A hospital stay can be traumatic. If you don't have adequate insurance, though, the real pain comes when the bills arrive. To wit:
You may face a wildly inflated bill. As backward as it may seem, hospitals often charge uninsured patients far more than the discounted prices given to insurance companies and government programs such as Medicare and Medicaid. The "sticker price" for rooms, drugs and medical care for an uninsured person can be two or three times the price paid by insurers, according to the National Consumer Law Center.
The hospital may not tell you that you could qualify for free care or discounts. Most hospitals have some kind of financial aid for strapped patients. A typical charity program would erase bills entirely for people whose incomes equal 200% or less of federal poverty limits, and it would offer discounts for those with incomes up to 400% of those limits. But hospitals may not publicize these programs or provide much guidance on how to apply.
| Federal poverty limits | |||
|---|---|---|---|
People in family | Contiguous U.S. | Alaska | Hawaii |
1 | $10,210 | $12,770 | $11,750 |
2 | 13,690 | 17,120 | 15,750 |
3 | 17,170 | 21,470 | 19,750 |
4 | 20,650 | 25,820 | 23,750 |
5 | 24,130 | 30,170 | 27,750 |
6 | 27,610 | 34,520 | 31,750 |
Source: Federal Register, January 2007 | |||
You may face increasingly aggressive collection tactics. Swelling amounts of bad debt have led many hospitals to remove the kid gloves. Collection calls and a trashed credit rating are just the start; you may face lawsuits, wage garnishment and liens on your home.
Such heavy-handed techniques have led a few states, including California, New York and Illinois, to place limits on the prices hospitals can charge the uninsured and on how debts can be collected. But those laws are the exception, not the rule.
"A handful of states have put into place some protections for the uninsured and the underinsured," said Chi Chi Wu, a staff attorney for the National Consumer Law Center. "In the majority of states, there are no legal protections."
7 ways to handle the hospital
With that the case, you need to know how to protect yourself if you're facing a big hospital bill and your insurance is inadequate or nonexistent:Don't stick your head in the sand. It may be human nature to wish problems away or to hope some windfall like a winning lottery ticket will bail you out of your financial problems. Failure to act on your hospital bills, though, is just dooming yourself to trouble. The hospital may interpret your silence as an unwillingness to pay your debts rather than an inability to pay them.
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Check your bills for errors. Hospital bills are notorious for being riddled with mistakes. You may have been charged for drugs you never took or for a full day of care when you checked out at noon, or charged twice for a single procedure. You won't be able to tell all that, however, from the summary bill that's typically sent to patients. To get the goods, you need to ask for three documents (all of which you're entitled to):
- An itemized copy of your bill.
- A copy of your medical chart.
- A copy of your pharmacy ledger. This shows the drugs you were given during your stay.
Compare your chart and ledger to the itemized bill to see if there are any discrepancies. Also, look for charges that are the result of hospital error, such as an X-ray that had to be redone because a technician goofed. You shouldn't have to pay for someone else's mistakes.
Other errors, such as "upcoding," are more insidious. Upcoding is a fraud that involves pretending a condition is more serious than it actually was, in order to charge more.
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Are workers' health-care expectations too high?Some employers and health-care experts say a partial solution to rising costs may be insurance plans with higher deductibles coupled with health savings accounts.
If the bill is too baffling, you don't necessarily have to wade through it alone. Some hospitals offer auditors that will help you review your bill. You also could use an outside service; Medical Billing Advocates of America offers referrals.
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