Since health insurance companies have rolled back waivers for hospital costs related to COVID-19, a COVID-19 hospitalization could result in a startlingly high bill from health care providers, according to a recent study from the University of Michigan and Boston University.
Of people who had private insurance from March 2020 to March 2021 and were billed for a COVID-19 hospitalization, the average out-of-pocket cost was almost $4,000. Among people with Medicare Advantage , the average bill was about $1,600. This included hospital care and physician services.
It can be stressful to face a high medical bill for something that’s out of your control, particularly if a case of COVID-19 prevented you from working for a while or left you with lingering health issues. However, hospital bills can sometimes be adjusted or negotiated down. Here are some strategies you can try.
Gather your materials, including all your bills, your insurance card and any explanations of benefits that you’ve received. Review your COVID-19 hospital bills and make sure you recognize all of the charges.
“Do you remember getting that MRI?” says AnnMarie McIlwain, CEO of Patient Advocators in New Jersey. (Patient advocates help clients with medical challenges, from finding the right treatment to handling billing and insurance issues.) “Did you actually talk to that gastroenterologist? There are frequently charges on bills that are false, that shouldn’t be there.”
Also double-check that each claim appears to have been processed correctly by your insurer. Typically, a processed claim will show a plan discount and allowed claim amount, plus any payment from the plan if you’ve met your deductible for the year.
“If you don’t see a payment or adjustment, there’s a chance they didn’t file,” says Jennifer Kastner, owner of Patient Advocacy Solutions in Georgia. Your insurance may also have denied the claim, so follow up with your insurer before you start working for a bill adjustment.
Nerdy tip: An explanation of benefits, or EOB, is a statement from your health insurance company that tells you how the company is covering the medical care you received. It’s not a bill.
If you’re dealing with a larger medical bill than you can handle, call the hospital billing office and ask if you qualify for financial assistance or financial relief. This is sometimes called charitable assistance.
“The worst they can say is ‘No,’” says Caitlin Donovan, a spokesperson for the Patient Advocate Foundation, based in Virginia.
If you’re planning to ask for assistance, you’ll need some basic financial numbers. “You’re going to want to know generally how much you make in a year, what you can afford to pay per year and what you can afford to pay upfront,” Donovan says.
You can also ask about a payment plan, which will allow you to pay your hospital bill over time. Generally, these don’t charge interest, so they’re a better option than putting a big medical charge on your credit card or taking out a loan. “You won’t have to worry about medical bills showing up on a credit report, which is not what you want,” says Donovan.
Just make sure you can handle the monthly payment for the long term. “You don’t want to get into a situation where you can’t afford to pay that bill and it ends up going to collections, or you end up cutting corners in other parts of your life where you really shouldn’t,” Donovan says.
If you’re in a position to offer an all-cash payment for a sizable part of the balance, try it.
“Cash is a word they like to hear in the billing office, and if you’re willing to pay something off quickly and via cash, sometimes they will give you a percentage off,” McIlwain says. “I would say 20% [off] would be a good number to propose.”
That said, McIlwain says if you’re feeling like the bill seems too high to handle, you’re probably not in a position to make an 80% payment on the balance.
If you’re dealing with a bill from a local hospital and you need help, see if it’s possible to visit the billing office or billing window.
“It’s a lot harder to not have compassion for someone when they’re standing in front of you,” McIlwain says.
If you can’t go in person, do your best to stay calm on the phone. Try and make the person on the other end of the phone your ally in your journey to solve this problem. Getting mad or angry is a natural reaction, but it won’t help. “They’re more inclined to try and get you off the phone quickly when you allow emotion to get the better of you,” says McIlwain.
Once you start this process, keep track of every step. Write everything down in a notebook or keep a digital document or spreadsheet with a note on every phone call, every letter sent and every person you talk to (and what they say). When you send a message through a patient portal, make a note of it. The better your records, the more equipped you’ll be to explain how diligently you’ve worked to take care of your bill.
Another tip: When you’re speaking to the insurance company, always ask for a reference number.
“These people are getting tons of calls a day,” Kastner says. “You want to have reference numbers to refer to.”
It may happen that, despite your best efforts, you can’t resolve a crippling medical bill, or you find it too overwhelming. A patient advocate may be able to help. This is a person who can make phone calls on your behalf — to your medical providers, the hospital, your insurer and any other parties that may be involved. Typically, patient advocates are experienced in areas like health care, insurance and medical billing.
Prices can vary for this. Some organizations charge a flat fee, while others charge a percentage of whatever they save you. The Patient Advocate Foundation is free for patients who have a serious or chronic health condition.
“One of the problems with the whole system is that we’re talking about people who are sick, who are tired, and who are dealing with new diagnoses,” Donovan says. “And we’re asking them to do a lot of work. So asking for assistance, be it just having a family member be on the phone call or asking a professional to help you, is always a good idea.”