At some point in your life you’re going to have to deal with a hospital bill. If you’re lucky it’ll be for an outpatient service like lab work or an x-ray instead of needing surgery or being an inpatient.


Hopefully you’ll have insurance to take care of the bulk of the bill, no matter what it is. Whether you do or not, there are some options you have that can help you pay your bill and possibly even get it taken care of without any out of pocket money. You have to be willing to work with the people at the hospital, and you might have to do a few uncomfortable things, but it can help to relieve some of the tension associated with health care costs.

The first thing you need to know is that every hospital has a charity care program. Well, let me rephrase that; every “not for profit” hospital has a charity care process. If your hospital participates in the Medicare and Medicaid plans, they’re required to have charity care options, and some “for profit” hospitals don’t participate in those plans. However, most for profit hospitals also provide charity care programs, so it’s worth asking about. In some states, nonprofit hospitals are required to put signs up indicating they have these programs but most of the time patients miss those signs.

We should start with a quick definition of “not for profit (or nonprofit) and “for profit. The main difference between the two is that any profits made by a nonprofit hospital goes back into the hospital, while profits at for profit hospitals are split between the hospital and its share holders, some of whom often allow some of those profits to be reinvested back into the hospital. Usually for profit hospitals are part of large systems of hospitals, whereas nonprofit hospitals for the most part have affiliation agreements, with the exception often being large religious based hospital systems.

Charity care is used as a way to give free or discounted care to people who qualify for it. It’s mostly based on income and family size, along with not qualifying for Medicaid. All nonprofit hospitals will try to qualify you for Medicaid if your income is borderline, whereas for profit hospitals that don’t participate with Medicaid will have their own criteria. The process involves proof of income, credit checks, and in some cases being asked to show either the previous year’s tax form if you’re not employed or 3 or 4 pay stubs from every adult member of the family presently working.

Depending on the hospital, if you qualify you could have one of these things happen for you:

* all debts absolved within a certain time period;
* debts associated with the largest balances absolved
* a sliding scale discount of absolved debt based on income
* a determination that you qualify for Medicaid

If all of your debt isn’t absolved, or if you don’t qualify for a charity care discount, hospitals are always willing to allow you to go on a payment plan. Payment plans are standard, but how they manifest themselves isn’t. Some hospitals will accept very small payments even on large balances over time. Some will require that the monthly payment amount pays the balance off within 3 to 6 months, no matter what the outstanding balance is. It’s unfair if that’s the case, but it’s not the norm for the majority of hospitals.

Something most hospitals don’t want you to know is that if you send in at least $20 a month, many computer systems will take the payment and start your billing cycle over. For some systems, as long as an adequate payment amount is coming in, they’re not going to bother you. The reason for this is that there are literally tens of thousands of accounts the billing staff has to work on, and there’s more attention paid to accounts that have no payments rather than small payments. Making sure you make a payment every 30 to 45 days isn’t a guarantee that you’ll never be contacted, but it often works.

A few hospitals will have other options set up to help you with your hospital bill. One of those options are companies that purchase your debt and allow you to treat it like a loan you can pay off at a certain annual percentage rate. In this way hospitals get cash they might never have received and monthly payment rates might be lower than what some hospitals might have agreed to.

The one thing you don’t want to do is totally ignore your hospital debt. It never goes away, and unlike 20 years ago it will hit your credit report negatively and mean something. Also, hospital records will always know if you skipped out on them because every medical facility must keep all medical and financial records for at least 6 or 7 years (in some states up to 20 years), and this will allow them to refuse to provide medical treatment except in emergency situations.

People who work collections at hospitals are some of the nicest people around, and they really are trying to help you. Give them a call if you need help.

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