Get Help Paying Medical Bills

You may qualify for financial assistance from a variety of different programs, including government and nonprofit organizations. Billions of dollars of funds are generally issued each and every year to address medical needs. There may be grants available from local or national stimulus packages, hospital chains, pharmaceutical companies, nonprofits. Availability and eligibility can vary widely depending on where you live and your condition, but the programs generally focus on helping low- to moderate-income households

If you have already received your health care, and now have outstanding medical bills or debts that are owed to a provider, then assistance is available for that as well.

Government Benefits

Assistance Programs

Medication Coverage

Nonprofit Hospitals

Medical Billing Advocates

Government benefits

Benefits.gov

Benefits.gov will help you find government benefits to which you may be entitled. A short online questionnaire will help direct you toward the benefits you can apply for, including those that help with health care and child care.

Assistance Programs/Organizations That Help Pay Medical Bills

HealthWell Foundation

The HealthWell Foundation runs several funds that may help with premiums and copays. Their telephone number is (800) 675-8416.

United Healthcare Children's Foundation

Can assist the underinsured with sick or injured children. Their telephone number is (952) 992-4459.

Vision USA

The Vision USA Foundation may help with glasses or eye exams. Their telephone number is (800) 766-446.

The PAN Foundation (Patient Access Network)

The PAN Foundation’s mission is to help underinsured people with life-threatening, chronic and rare diseases get the medications and treatments they need by assisting with their out-of-pocket costs and advocating for improved access and affordability. Their telephone number is (866) 316-7263.

The National Association of Free and Charitable Clinics (NAFC)

The NAFC uses a volunteer/staff model to provide a wide variety of health and medical services to economically disadvantaged patients. These clinics and pharmacies restrict the ability for services to patients who are uninsured, underinsured, or have limited or no access to primary, specialty, or prescription health care. Their telephone number is (703) 647-7427

Leukemia & Lymphoma Society (LLS)

The LLS has several financial assistance programs that may help with travel expenses, copays and urgent needs (including rent, utilities and food). Their telephone number is (914) 949-5213

Medication Coverage

NeedyMeds

NeedyMeds is a nonprofit organization that assists people who cannot afford prescription drugs and other medical costs. They are an information source, allowing you to find programs that may help.Their telephone number is (800) 503-6897

Rx Assist

Rx Assist offers a comprehensive database of Patient Assistance Programs, or PAPs, which pharmaceutical companies run to provide free medications to those who cannot afford them. Email: info@rxassist.org

Rx Hope

Rx Hope is a web-based patient assistance resource, providing vital information and help to those who need help affording their prescription drugs. You can fill out a Patient Assistance Request on the website.

Pharmaceutical companies

Some companies that create and sell prescription drugs and medical supplies have patient assistance programs (PAPs) that may offer you free or low-cost medications. The Medicare website has a search tool that you can use to find PAPs using a prescribed drug's name.

Nonprofit hospitals

Federal law requires nonprofit hospitals to provide financial assistance to qualified low-income patients who can't repay their medical bills, so check whether the hospital treating you is a nonprofit. Applicants will need to show proof that their income is low enough to qualify, such as pay stubs, tax returns and other financial documents. "If they qualify, (patients) will have a bill that is reduced or completely written off," Lamb says. That means you may even get out of paying your medical bills.

Even if the hospital operates as a for-profit institution, it might choose to offer one of these programs voluntarily or be required to provide financial assistance by state law, so it's worth checking.

It's also worth applying for financial assistance, even if you suspect that you might not be approved, experts say. These plans often work on a sliding scale, so you may still get 20% off your medical bill or more.

Medical Billing Advocates

Medical billing advocates won’t pay your medical bills for you, but they can help get your bills reduced.

These advocates know medical billing inside out. They can spot medical billing errors you might not catch yourself. Additionally, they may know what billing items can be negotiated to lower prices than what you’ve been billed.

A billing advocate that reduces your medical bills essentially reduces your medical debt. Unfortunately, billing advocates often charge for their services, and sometimes, they can be expensive. However, you may be able to find free assistance through your workplace’s benefits program. Another option could be through charitable organizations like the Patient Advocate Foundation.

HIPAA & FCRA Compliance in Medical Debt Collection

The Fair Credit Reporting Act (FCRA) and the Health Insurance Portability and Accountability Act (HIPAA) generally allow to report medical debts to consumer reporting agencies, though some restrictions apply.

Policies of the CRAs also impact what information can be reported regarding medical debts.

The FCRA permits health service providers and their agents to furnish information about medical debts to consumer reporting agencies (CRA). However, the Act requires furnishers to encrypt certain information to protect the consumer’s privacy. Likewise, HIPAA allows medical providers or their debt collector to report medical debts to the CRA provided that the information used is limited to the minimum amount necessary. The CRAs themselves also have certain policies that impact the furnishing of medical information.

I will now provide an overview of the requirements for furnishing information on medical debts under the FCRA, HIPAA and the CRA policies.

FCRA:

The FCRA (Fair Credit Reporting Act) allows to report information arising from the receipt of medical services, products or devices. However, the name, address, and telephone number of any medical information furnisher may not be included in a consumer report unless the information is coded in such a manner that the name of the provider and the nature of the services cannot be inferred by a person other than the consumer

Medical information is defined under the FCRA as:

Information or data, whether oral or recorded, in any form or medium, created by or derived from a health care provider or the consumer, that relates to—(A) the past, present, or future physical, mental, or behavioral health or condition of an individual; (B) the provision of health care to an individual; or (C) the payment for the provision of health care to an individual.

The FCRA establishes a class of data furnishers termed “medical information furnishers.” A medical information furnisher is defined as “a person whose primary business is providing medical services, products, or devices, or the person’s agent or assignee, who furnishes information to a consumer reporting agency [CRA] on a consumer.”5 Examples include doctors, dentists, hospitals and their agents (such as a health care debt collector) that furnish information about consumers to a CRA. Medical service providers and their agents must register as a medical information furnished with each CRA to which they report medical debts.

Time Period for Reporting Medical Debts

Similar to most other consumer debts, medical debts may generally be reported for a period of seven years, unless state law provides for a different time period. The seven-year reporting period begins to run 180 days after the date of delinquency. The date of delinquency is the month and year of the commencement of the delinquency on the account that immediately preceded collection activity or the account being charged to profit and loss

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HIPAA

HIPAA permits medical providers to share information with their agents for any purpose that the Department of Health and Human Services (HHS) has deemed permissible without authorization under the Health Insurance Portability and Accountability Act of 1996 (HIPAA).

HHS has stated that HIPAA regulations permit the disclosure of medical information for the purpose of obtaining payment on medical goods and services, including reporting medical information to a CRA. 15 Thus, health care providers and their agents are able to report medical debts to CRAs without violating HIPAA. According to HHS:

The Privacy Rule permits a collection agency, as a business associate of a covered health care provider, to use and disclose protected health information as necessary to obtain reimbursement for health care services, which could include disclosures of certain protected health information to a credit reporting agency, or as part of collection litigation.

The HHS Office for Civil Rights also provided the following question and answer on the HHS website:

Question: Does the HIPAA Privacy Rule prevent reporting to consumer credit reporting agencies?

Answer: No. The Privacy Rule’s definition of “payment” includes disclosures to consumer reporting agencies. These disclosures, however, are limited to the following protected health information about the individual: name and address; date of birth; social security number; payment history; and account number. In addition, disclosure of the name and address of the health care provider or health plan making the report is allowed. The covered entity may perform this payment activity directly, or may carry out this function through a third party, such as a collection agency, under a business associate arrangement. The Privacy Rule permits uses and disclosures by the covered entity or its business associate as may be required by the Fair Credit Reporting Act (FCRA) or other law. Therefore, the Department does not believe there is a conflict between the Privacy Rule and legal duties imposed on data furnishers by FCRA.

It should also be noted that the Privacy Rule generally requires that medical information that is used by a medical provider or its business associate should be limited to the minimum amount necessary for the purpose of the use or disclosure.

Medical collection agency

Can medical debt impact a credit score

Your medical history is certainly not part of a credit report, but past due medical debts can affect your credit reports and credit scores if a doctor or hospital hires a medical debt collection agency to pursue payments.

Medical collection agency

A sickness, illness or surgery can result in unexpected and unplanned medical bills. While health insurance may help, many people still struggle to pay medical bills while trying to put food on the table.

As of Sept. 15, 2017 the three major credit bureaus (Experian, TransUnion and Equifax) employ a 180-day waiting period before medical debt appears in a credit history. This six-month grace period is designed to give you time to correct any errors on your bill, pay the bill or get your insurance company to pay it, figure out a payment plan or otherwise resolve the problem.

Medical debts are given less weight: Newer scoring models weight medical collections less than other types of collections so that they don’t impact a score as much. However, not all creditors use these new scoring models, so medical collections could still hurt your credit.

When you receive your bill, be sure to examine it carefully and compare it with the explanation of benefits provided by your health insurance provider. If you believe you've found an error, contact your medical provider or health insurance company.

If you’re facing mounting medical expenses, here are some things you may want to consider that may help prevent medical bills from appearing on credit reports:

Contact your health insurance company. Know your coverage and follow up to ensure the company is paying costs it has agreed to cover.

Negotiate with your health provider. If you can’t afford to pay a bill, try to work with your medical provider to reduce the amount owed or set up a payment plan.

If you believe medical debt has been listed on your credit report erroneously, contact the medical provider or collection agency first. You can also file a dispute with the three major credit bureaus.

If possible, prepare for medical procedures in advance by finding out what your insurance will cover and what costs you’ll be responsible for.

It’s always a good idea to regularly review your credit reports to ensure the information is accurate and complete. You’re entitled to a free copy of your credit report from each of the three credit bureaus every 12 months.