So I went to a hospital the other day and was told I have a de-deductible of $3,000. I am not sure how much my insurance paid (if anything). At some point I have to talk to the hospital about payment and I want to talk them down to accept a lower amount. I do have some savings to offer, but I would like to get them to agree to take that amount and write off the rest rather than just admit I have that safety net and still have payments.
If it helps the discussion my insurance is supposed to be “managed”. Which means that I call them and they then tell me where I can go and not have to pay anything out of pocket. It just happened that I had been having some pretty bad stomach issues I was hoping would go away. I then realized I had spend just under 2 days like this, but it was memorial day so their number was closed and any small clinic, so I went to the ER worried my appendix was bursting or something serious was happening to me.
Call the hospital, get the billing department ask if you can talk to someone about reducing the bill.
I had a similar situation once, said my chest hurt and everyone freaked out and I ended up with a 5k ER bill. With no actual answer to why my chest hurt, and was still hurting.
I talked to the hospital they set up an appointment with a woman, I showed bank statements, income, insurance information. Ultimately, because I had very little income or money at the time. They just forgave the entire amount. No more bill.
Definitely worth a shot.
I will definitely be doing that.
Wanted to add to this: if it can’t go away, it’s likley you can set up quite a long repayment at 0% interest. It will still hurt but at you can spread it out
Ask for an itemized bill.
Man, every time I read anything about the US healthcare system it gets more dystopian - I’m sorry you are having to deal with this nonsense
Most (all?) health insurance companies in USA have clauses in their agreements with in-network providers (ie doctors, hospitals, pharmacists) to permit a covered patient to first receive the Explanation Of Benefits (EOB) document from the insurance company first, before having to pay a provider. In fact, waiting for the EOB is highly advisable, because paying a provider’s bill in-full and then later having to obtain a refund because the insurer paid out is akin to pulling teeth (that is, painful and difficult).
The EOB also shows which claims the provider actually filed with the insurance company, which if full-and-complete means you should not expect to make any further payments for services received.
To be clear, the EOB also includes any amount which the covered patient is known to have paid at the time of service. For example, most in-network doctor’s offices will charge the insurance policy’s copay on-the-spot before seeing the doctor, since this is a known, fixed amount and insurance will pay the doctor some sort of negotiated remainder.
You should verify the EOB reflects any copays you’ve already paid, and that the costs have accrued toward whichever deductible applies to you – more than one deductible can be at play.
To answer your question directly, I would not start any negotiation until you have the EOB in hand, because otherwise you are negotiating blind: you won’t know which claims have been filed, and you won’t know how much insurance has agreed to already pay.
Thank you for your response. I will be reading the links you provided!
As an aside, regarding USA health care public policy, I think provider-issued bills need to be abolished, where the only bill that insured patients receive is a single, consolidated bill that comes from the insurance company, at the same time the EOB is sent, with plentiful payment and financing options.
Not only does this reduce patient confusion, it saves money for providers (who don’t need to follow-up on late payments), it reduces the need for providers to issue refunds, and patients benefit because it’s a single bill at the end. The only downside – maybe – is that forgiveness of a medical expense must file paperwork with the insurance company, to be reflected on the consolidated bill. But this would still be a massive improvement.
Or, instead, maybe just go the full shilling and have a national, single-payer, universal health care system. Baby steps or big leaps; take your pick.
There were some good tips in this podcast episode: https://www.npr.org/2023/07/28/1190725808/tackle-your-medical-debt-with-life-kit
They often have a cash price that’s cheaper, but if you ask for that they won’t bill your insurance and you’ll never meet your deductible.
Why would that not contribute to a deductible?
The deductible is an amount that you pay out of pocket before insurance starts covering anything. So if insurance doesn’t get billed, the money doesn’t count towards the deductible. This may make it difficult to lower the bill at all, it really depends on how much the entire bill is compared to your deductible. If you can’t pay it though, they’ll have to give you an affordable payment plan. Definitely negotiate and don’t take a loan out from some other source to cover.
If you don’t expect to meet your deductible, like if it’s near the end of your insurance year, asking for a cash price is a good option.
Its pretty hard to get off with as low as a few k from the ER. Just going there would likely hit the deductible.
