Attaining sound financial decisions for another person can be very overwhelming, particularly when it comes to health care. Selecting the right Medicare plan for your loved one is critical during the year’s annual enrollment, but out-of-pocket costs are not covered by Medicare. This is a major financial burden. There are steps that caregivers can take to help reduce these out-of- pocket expenses. Here are tips to help you take control and lower medical bills:

  • Understand paperwork and check the basics:  Make sure that the bill has the correct basic information.  The medical provider will send a bill showing what should be paid.  Insurance company sends an Explanation of Benefits (EOB) explaining why that amount should be paid.  This EOB will state the retail rate of the service received, the contracted rate the provider agreed to accept as payment in full, and how much the insurance company will pay and how much you should pay.  Out-of-network providers are providers that do not have negotiated contract rates with the insurance companies.  There providers do not agree to a lower rate and can charge anything they deem appropriate.  Your insurance policy will determine what the insurance company will pay.
  • Do not pay immediately but do not ignore bills:  Medical bills are different from other bills you receive and require closer examination.  Do not pay the bill until you have determined the amount billed is what you truly owe.  Take the time to ensure your bill is correct but do not ignore the provider’s request for payment.  Let your provider know that you are working on the bill and request that they do not send the account to a collection agency.  They will often give you extra time to resolve issues. Ensure your bills are correct before paying them, but do not let them pile up without any action.
  • Understand and verify the charges:  Don’t pay what you don’t understand. Request an itemized bill from your provider. Go through the itemized bill to ensure the services were indeed received.
  • Ensure the bill is adjusted for contracted rates and insurance payments:  If your bill does not contain line items that show an adjustment for the contracted rate of insurance payments, that means your insurance was not applied to the bill.  Instead of working the issue out with your insurance company, the provider billed you instead. If a bill does not reflect insurance payment or insurance discount, it is a sign that it may be billed incorrectly.
  • Check that the EOB matches the bill:  Ensure you have an EOB for a bill before making a payment.  The EOB should state exactly what to expect the provider to bill you for the service.
  • Be persistent and don’t back down until the issue is resolved: Call the provider and your insurance company immediately to resolve the issue.  Document all your phone calls.  Write down the name of the person(s) you spoke to, as well as date and time.  Follow up until the issue is resolved and you receive a revised, corrected bill.
  • Ask for an interest-free payment plan or application for financial assistance:  If you have determined that the bill is correct, but cannot pay the bill all at once, ask your provider if you can arrange for an interest-free payment plan.  Once the provider has allowed you to set up interest-free monthly payments, be sure to keep up your end and make these monthly payments on-time.  Providers and hospitals often have financial assistance programs available to those who meet the income requirements.  Most programs like this will require proof of income documents.  If you qualify and are accepted, your bill can be significantly reduced.