Ever receive those medical bills in the mail and your stomach drops? The totals seem impossible. How could you ever pay for that emergency room visit or broken bone? Your spirits drop even further when you realize some of it may not be covered by your insurance. We’ve all been there.
Anxiety starts to rise as you wonder how you’re going to afford the medications, treatments, and appointments needed for you or your family member to get well. But take a deep breath. There are options and help available so you don’t need to panic. In this blog post, we’re going to explore different ways to get financial assistance paying medical bills, from payment plans to local and national programs. Let’s get started before the debt collector starts ringing!
Understanding Your Medical Bills and Costs
The first step is to get an itemized medical bill from your doctor or hospital that lists the procedures, tests, or treatments. Check each charge closely to be sure there aren’t errors or duplicates. If anything looks off, call to have it corrected.
Insurance
Once you have the correct bill in front of you, it’s time to figure out what you actually owe versus what your insurance should cover. Check your insurance plan details or call your insurance provider to determine your out-of-pocket costs such as copays, deductibles, and coinsurance. Look if some of the services on your bill require preauthorization or have insurance coverage limits.
Cash Discount or Payment Plan
You may be able to lower some costs by asking if your provider offers a cash discount or payment plan for patients without insurance. Discuss any financial hardship with your hospital’s billing department to check if they can work with you. Some may lower or drop certain charges altogether.
Shop Around
Don’t hesitate to shop around at different hospitals or clinics to compare prices for common procedures. Costs can vary greatly between locations for the exact same services. If possible, choose an in-network provider since they charge lower, negotiated rates.
Navigating Health Insurance for Maximum Coverage
You’ve got health insurance, but do you really understand how to use it to get the most out of your coverage? It does pay to get savvy about the in and outs.
- First, know your plan details. Study your policy to learn what’s covered, any limits or exclusions, and out-of-pocket costs like copays and coinsurance.
- Need referrals? Many plans require a referral from your primary doctor before seeing a specialist. Get referrals in writing and check that they specify the number of approved visits.
- Check what’s in your network. Which specific doctors, hospitals, and other providers are in your insurance network? Using in-network providers saves you money. Search online or call your health insurance company for a list.
- Don’t be afraid to appeal if needed. If your insurance denies a claim, you have the right to file an appeal. Submit a letter with details about your situation and your medical expenses.
Medicaid
If you’re struggling to afford health insurance — Medicaid provides health coverage for low-income individuals such as children, pregnant women, the disabled, elderly, and parents of dependent children.
To qualify for Medicaid, you must meet certain income requirements, which vary by state and eligibility category. Typically though, you need to have an income below a certain threshold. Medicaid eligibility is based on your Modified Adjusted Gross Income (MAGI). Some of the things counted in your MAGI :
- Wages, salaries, tips, etc.
- Interest
- Social Security benefits
- Self-employment income
- Unemployment compensation
Medicaid Services
Once you’ve applied for Medicaid and been approved, medical services are covered at almost no cost to you, depending on your state’s rules. This could consist of things like:
Hospital stays
- Doctor visits
- Vaccines
- Nursing homes
- Home health
- Mental health
Medicaid provides a lifeline to help with medical bills. While the eligibility criteria and benefits vary significantly between states, Medicaid aims to provide basic health coverage for vulnerable populations across America. Don’t hesitate to apply and see if you qualify for this essential program.
Children’s Health Insurance Program (CHIP)
The Children’s Health Insurance Program, also known as CHIP, provides low-cost health coverage for children in families that earn too much to qualify for Medicaid. CHIP covers routine checkups, immunizations, prescription drugs, hospital care, and more.
- Each state offers CHIP coverage, and works with Medicaid. The financial assistance programs offer the same essential benefits but have different income requirements. In most states, children up to age 19 can enroll in CHIP if their family’s income is too high to qualify for Medicaid but too low to afford private health insurance. Some states offer coverage up to age 21.
- To apply for CHIP, you’re going to need information like income statements, social security numbers, and information on any health insurance you currently have. You can apply for CHIP anytime. There are no enrollment periods like the health insurance marketplace.
- CHIP premiums and out-of-pocket costs such as co-pays are typically much lower than private health plans. Some families pay monthly premiums of $10 to $50 each child, while others pay nothing. Out-of-pocket costs are also kept low.
- If your child qualifies for CHIP, their coverage will begin as soon as their application is approved. CHIP offers comprehensive coverage to keep children healthy. Don’t delay – apply today to get your child insured and access to the care they need.
Understanding the Affordable Care Act (ACA)
The Affordable Care Act helps make health insurance and medical care more affordable. There are provisions in the ACA that can help lower costs for many Americans.
Premium Credits
If you purchase health insurance from the health insurance marketplace, you may be eligible for premium credits. These tax credits reduce your monthly health insurance premiums. To qualify, your income must be between 100% to 400% of the federal poverty level. The lower your income, the more help you’re going to receive.
Cost-Sharing
Cost-sharing reductions are available for those with income between 100% to 200% of the poverty level. These subsidies reduce out-of-pocket costs like your deductibles, coinsurance, and copayments. The less you earn, the more help you get.
Medicaid Expansion
The ACA expanded Medicaid coverage to more low-income individuals. If your state participated in the Medicaid expansion, you may qualify for Medicaid if your income is up to 138% of poverty. Medicaid covers essential health services and you face no or very low out-of-pocket costs.
- Check if you qualify for savings in the health insurance marketplace based on your income and family size. You can apply for premium tax credits and cost-sharing reductions when purchasing a plan.
- Look into if your state expanded Medicaid. If so, you may qualify based on your income. Medicaid provides comprehensive coverage at little or no cost.
- Look into a free or low-cost medical provider in your area. They provide basic care on a sliding-fee scale based on your ability to pay medical bills.
- Ask hospitals about their medical bill assistance programs. Many hospitals offer free or discounted care to patients on a budget. Provide proof of income to determine eligibility.
The ACA offers many provisions to make health insurance and health care more affordable for Americans. Take advantage of the options available to you, and don’t hesitate to get the care you need. There are always ways to find help paying medical bills, you just have to know where to search.
EASY Wireless’ FREE Phone Plan
If you’re reading this blog, you’re likely either facing huge medical bills or worrying about unpaid medical debt. Don’t worry — it happens all the time. Luckily, EASY Wireless is here to help!
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EASY Wireless Unlimited Plan
- FREE Unlimited Data
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- Choose to Keep Your Number or Get a New One
