MARY LOUISE KELLY, HOST:
In the U.S., medical debt as a whole is over $200 billion, which sounds overwhelming. So today, we are taking a practical approach to the topic because there's a well-kept secret about the astronomical dollar amounts on your medical bills.
JARED WALKER: They're fake numbers. They can be negotiated.
KELLY: That is Jared Walker, founder of the nonprofit Dollar For. He says these bills also can be inaccurate and you may not have to pay them at all, depending on your income. Life Kit host Marielle Segarra has more.
MARIELLE SEGARRA, BYLINE: Walker says, when you get a medical bill, the first thing you should do is find out if you qualify for something called charity care. Under federal law, nonprofit hospitals are required to have these policies.
WALKER: To keep their nonprofit status, they have to provide free or reduced care to patients within a certain income range. Typically, a policy will say something like if you're at or below, you know, 300% of the federal poverty guideline, then you're eligible for free care or reduced care.
SEGARRA: Unfortunately, nothing about this process is straightforward. The income cutoff for charity care can be different depending on the hospital and sometimes the state you're in. Also your hospital may not volunteer that you're even eligible for charity care. To find out more, do a web search for your hospital name plus the phrase financial assistance, and find the application.
WALKER: Typically, it's like two pages. Who are you? Who do you live with? Where do you work? How much money do you make? And it's like, then prove it - proof of income, pay stubs, tax return and all that. So you fill all that out and submit it to the hospital through whatever wacky way they do that, typically through fax or mail or whatever. And then you can wait a couple weeks and then just check in as often as you like. I typically bother them a lot about it.
SEGARRA: By the way, for-profit hospitals often have these policies as well, though they're not required to by federal law. If you don't qualify for charity care, the next step is to ask the hospital for an itemized bill and take a look at everything on it. Did you actually have that procedure done? Walker says it's common to find errors.
You may also find things on your bill that are accurate but seem like an overcharge, like 100 bucks for a couple bandages or aspirin. Take note of those and bring them up to the billing office. Even if your bill is technically correct, you can negotiate. One way to do that - if you have savings and you can afford to pay something upfront, call the billing office and ask, what's the settlement amount?
WALKER: Like, what will you take right now if I can close out this account? Typically, we can get 30- to 50% off just by asking that. If I pay you right now, what can I get lowered off this bill?
SEGARRA: If you can't afford this approach, you can still negotiate. Ask what they can do to lower the bill. And you can get on a payment plan. That's typically better than putting the debt on your credit card because often hospitals will not charge interest.
Lastly, remember that this is a long game. You may not get anywhere with the first couple calls, but keep plugging away at it or ask a family member or friend to help you follow up. And keep in mind that while medical bills may seem urgent, especially when they say due upon receipt, you have a lot of time before they're sent to collections or they affect your credit.
WALKER: There's no, like, sense of urgency, you have to pay this now. You can take a deep breath, get a plan and go from there.
SEGARRA: For NPR News, I'm Marielle Segarra.
KELLY: And for more Life Kit, you can go to npr.org/lifekit.
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