Facing large medical bills? How to ask for a payment plan

January 21, 2020 in Health finance  •  By Miles Varn, MD
Feeling Lost Without PinnacleCare

There are many reasons you could end up with large medical bills that strain your budget.

  • If you have a high deductible health plan, you could be required to pay several thousand dollars out of pocket before your health insurance starts to cover the cost of your care.
  • If you go outside your health plan’s network to seek care from an expert for a serious, rare, or complex health problem, you’ll need to pay a higher percentage of the total cost than you would receiving care from an in-network specialist.
  • Some healthcare providers, especially those in the mental health field, don’t accept any type of insurance because the reimbursement rates are low. In these situations, if you’re undergoing therapy for depression or anxiety or seeking treatment for substance use disorder, for example, you’ll need to pay the full amount up front and submit a claim to your insurer and see if they cover any portion of the cost.

Large medical bills are straining many people’s finances. One study conducted by the Kaiser Family Foundation noted that one in five Americans who are working age and have health insurance had difficulty paying medical bills. Of the people surveyed for the study, 63% report using most or all of their savings to cover the bills.

The impact of these large medical bills is not just financial. The study found that people who have trouble paying their medical bills forgo care they need like dental care, physician-recommended tests and treatments, and filling prescriptions, which can have a significant negative impact on their health over time.

What to ask before setting up a payment plan

One option that may help you manage big medical bills is working with your provider to set up a payment plan that allows you to spread the cost of care over a longer period of time. If you’re planning to undergo costly care like labor and delivery or surgery, it can be helpful to raise the issue of cost with your provider before you receive care and ask if they would be willing to set up a plan that would allow you to pay over time.

When working to set up a payment plan, be sure to discuss these key elements:

  • Will the provider charge interest on your unpaid balance? If so, what will the interest rate be?
  • Are there any fees associated with setting up the plan, such as fees for late payments or paying by credit card?
  • How long do you have to pay off the total amount?
  • Can you pay off the balance without penalty before the end of payment plan if your financial situation changes?

If your provider is willing to set up a payment plan, get the details in writing and review them carefully before you sign anything. You may also want to consider consulting a medical billing advocate. An advocate can not only help you request and negotiate a payment plan, she or he can review all your medical bills to make sure they’re accurate and may be able to negotiate with the healthcare provider to lower the amount you must pay.