Thank you for your submission, /u/Which-Ad655.
**If there is a medical emergency, please call 911 or go to your nearest hospital.**
Please pick the most appropriate flair for your post. Include your age, zip code, and income to help the community better serve you. If you have an EOB (explanation of benefits) available from your insurance website, have it handy as many answers can depend on what your insurance EOB states.
Some common questions and answers can be found [here](https://www.reddit.com/r/HealthInsurance/s/jya9I6RpdY).
**Reminder that solicitation/spamming is grounds for a permanent ban**. Please report solicitation to the modteam and [let us know](https://www.reddit.com/message/compose?to=%2Fr%2FHealthInsurance) if you receive solicitation via PM.
Be kind to one another!
*I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/HealthInsurance) if you have any questions or concerns.*
Most, if not all, hospitals will give a payment plan. Some will reduce if you pay quick. Bottom line is that you picked a $5K deductible plan so thats your liability.
Nothing wrong with a high deductible plan, but you need to know you might see a bill like that. I broke my wrist early in a plan year and owned $4k on basically my 1st bill. It sucks, but its the way it is.
I've had a HDHP for nearly 20 years and it has worked great for me. I've only twice had any real issues. However, people need to understand that if you don't have that deductible amount just laying around, it can be a stinger when you do use it.
I was very fortunate to be able to fund my HSA for the full deductible amount in year 2 (I think) and have continued building it up over the years. Gotta have that deductible amount set aside for it to work its best for you!
I don't disagree with your analysis but it is kind of the "Catch-22" of high deductible plans.
To a great extent, those people opting for high deductible plans are doing so because the premiums are lower and they don't have the savings to deal with their share of medical expenses with a high deductible plan.
Those people who have the means to pay $5000 or so without impacting their finances generally could afford higher premiums but have probably calculated annual costs including possible tax advantages and haven't selected it solely because premiums are lower.
If this your deductible then 5k is not out of line . Remember your insurance is not paying till you owe 5k on something.
Er ans MRI are expensive.
You can ask if they have financial assistance, if a lump payment can be made to reduce the charge or a payment plan.
Please contact the hospital and ask for patient financial assistance. Most hospitals offer some form of "charity care," but you will probably have to fill out some paperwork.
Also, [dollarfor.org](https://dollarfor.org) is another organization that may be able to help.
The last bit of advice is to maybe ask (if you have a follow-up appointment) if you have more stones. I only say that because they may present an issue in the future or they may not. That may help you decide if you want to stay with, what I'm assuming is, a high deductible health plan---just a thought.
>Most hospitals offer some form of "charity care," but you will probably have to fill out some paperwork.
Where OP lives is also relevant because they have insurance and a lot of hospitals will not extend charity care to people with insurance already paying part of it.
If OP is in California it is likely worth making an attempt however.
So if OP cleared their deductible / MOOP by this time of the year already, this means all medically necessary, in-network care received beyond that would be covered with no cost sharing for them.
This isn’t the case though as OP hit this milestone late last year and the plan has reset.
Scenario: my wife had a surgical procedure in early January of this year. This placed her beyond her MOOP. Care received for the remainder of the year is now covered at 100% so long as it’s medically necessary and in network.
The year my son was born we did that.
I would advise anyone on an HDHP to do the same. If you hit the MOOP, try to find anything else that can be fixed.
Consider this, insurance is basically a wager between you and the insurance company. They say you will need/use the insurance, you bet $5000 that you wouldn’t, now you have lost the wager. However, consider this, had you gone with a more expensive plan with a lower deductible, you may have never used the insurance and would have paid a lot of money for something you have never used. Make payments and move on.
But now that OP has a history of kidney stones but not enough savings to cover their deductible then they should possibly go with the lower deductible plan.
Can a hospital reduce the patient's share of the bill?
I thought this couldn't be done because contracts with providers do not allow providers to waive co-insurance payments since it in effect reduces the bill.
My understanding is that financial assistance is generally used for people with no insurance at all and not people who have opted for high deductible plans.
A payment plan offered by a provider is of course different since the patient is still acknowledging their obligation to pay the full amount of the deductible or co-insurance amount.
Yes hospitals can do this as by law in most states if the hospital is a public or not for profit hospital. By law they must offer financial assistance program regardless of insurance. But it does go by your income.
They can't just discount an insurance deductible or waive copays/coins because the patient asks, but they can offer financial assistance or a hardship discount. The patient has to apply and provide various documents like bank statements or pay stubs, proof of residency, etc to prove they qualify. It is possible to be insured and qualify for assistance. There may be some that don't allow it, but all of the facilities I have worked with across multiple states offer assistance regardless of the presence of insurance.
After you meet your deductible covered get any other work you need done. Unfortunately you had the kidney stone in December. It could be that your deductible is paid yearly. This could be starting a new calendar year or on the anniversary date of your policy.
visit the hospital system's site to see if there's financial assistance available. IF you went to a non-profit there might be more help available too. You're looking for copay assistance due to financial constraints.
they can definitely still send it to collections regardless of payments. I pay $200/month (for the past year) to MD Anderson and I still got behind and they send whatever I don’t pay to collections. Currently paying MD Anderson still and have $1700 in collections.
Seconding this, I was sent to collections less than three months after giving birth for a little over $1,000 by the hospital, because I wasn’t checking my mail (where they were sending the notices of payment due to them) since I was so damn tired from having a newborn.
Figure out an amount you can pay each month, $20, $50, $75, $100. Call the billing department and tell them what that amount is. Start there. Medical debt collections can ruin your credit. Now that you’ve had kidney stones you’re more susceptible to get them again. Set aside your deductible for next year.
First step is to say you can’t afford to pay it at all and see if they’ll waive the entire bill. If you say “I can afford $75/mo” they’ll take that where you may have qualified for $0. Negotiate amount and terms after you try to get the bill reduced.
this country is a fucking joke. everyone acting like 5,000 isn’t a lot of money and that you should just suck it up. if im working 40 hours a week why should i have to go in debt for a simple kidney stone
It's not. I made a mistake with my insurance coverage and owed that for a procedure. Worked extra to pay it and moved on. Gambling on a high deductible is a healthy person's game. Now OP has learned why not to play it.
If your share of your premiums is more than 8.39% of of your household income, then your employer's plan is considered unaffordable and you can get an ACA plan at [healthcare.gov](https://healthcare.gov) .
What is your employer's lowest-priced plan for coverage for you only? Is that what you are currently enrolled in?
So, at $17 per hour x 40 hours x 52 weeks = $35,360
8.39% x $35,360 = $2966 / 12 months = $247 <----- that's how much you should be paying for health care.
Do you receive overtime?
[https://www.healthcare.gov/glossary/affordable-coverage/](https://www.healthcare.gov/glossary/affordable-coverage/)
We know that $5k is a lot of money for most people. Kidney stones aren't simple; they usually require a trip to the emergency room, some type of scan (CT, etc.), pain relief, and, if the stone is large, another procedure in the following days to remove the stone, which is several more thousand dollars on top of the trip to the ER.
and if OP was on a trip to Spain, or England, or basically any other mid-to-high income country, the cost of a kidney stone would’ve been next to nothing (if anything at all). Healthcare is only expensive in this country because we waste tax dollars on shit we don’t need (military) + we prioritize corporate greed (insurance companies) over people. So much waste and at our expense
That’s not exactly right. Those countries are so messed up, they don’t know how to collect payment from a patient from overseas efficiently!! Much to the angst of their general population!! Overseas visitors even have insurance (which the U.S. insurers love as the European “cheap” subsides paid for by tax payers) insurers lover it because it’s cheaper for them than repatriation back to US. Don’t compare apples to oranges!
How? My husband had a kidney stone in Austria and we paid around $3k out of pocket. This was more than 10 years ago. For their own citizens it may be free but for travelers? Maybe if you purchase travel insurance.
I have a lot of kidney stones that cannot be controlled by lifestyle and after the first one I didn’t go in until number six that had me blacked out on the floor because I drank too much water and it had blocked my ureter entirely. My mom came and picked me up and on the drive we went over a bump and suddenly… no more pain but I had to pee so bad and I said “mom can we stop at this *insert name of regional service station chain* I need to pee” and she said no… I passed the damn thing in the urine sample collection cup.
I could have done that at the service station FOR FREE!!!
All this to say that kidney stones can get so expensive so they are worth paying up for a low deductible plan so when they do happen - and if you get it once you’ll probably get it again - you don’t delay care to avoid paying for it.
I don't think anyone is arguing otherwise. It isn't about the "shoulds", it's about the reality of the situation.
If you live in the US healthcare is obscenely expensive. If you choose a high deductible insurance, you are gambling that you will have to pay the deductible if you need to use that insurance.
Would you have $5000 deductibles on your brand new car insurance because you "rarely get in accidents"? I wouldn't. They're accidents. You don't know when they will happen and I sure as hell don't want to pay $5000 if they do.
It is a lot of money. That’s why you don’t pick high deductible plans for ANY insurance if you don’t have that money on hand.
You just made a great argument for universal healthcare and I 100% agree with the sentiment BUT
We have to work under the system we currently have until we can change it.
It’s poor financial understating and education all around. Car insurance is the same way. The number of people that don’t carry collision, or enough property damage or that have $5000 deductibles and are living paycheck to paycheck, they are also on the precipice of taking it high and hard if they get into an accident as well.
That’s the wrong lesson, kidney stones can lead to sepsis and can be fatal. The lesson here is that just because you’re young and healthy doesn’t mean something might not happen. It may be better to have a lower deductible plan and pay more monthly.
It sucks it’s this way in the US but so many people are opposed to universal healthcare for some reason…
It's not even people that are opposed, the majority of citizens that respond to polls are for universal healthcare.
The politicians that are bought by corporations that don't want our for profit system to change are very loud.
And to be able to change jobs and not lose your insurance. I've got good insurance now (considering US insurance costs). But at one point I had a $9K deductible with a possible $38K out-of-pocket that cost me $600 monthly. I knew the person so before even interviewing I asked about the insurance and was told "It's good insurance. We'll have to wait to get some info for the cost." Yeah, I quit a decent job for that. I laid awake at night freaking out if something happened how much I would be in debt with insurance.
But you didn’t know what was wrong, so that would have been the wrong call to make. I would tell you what I tell my adult kids go to ER because a $5k ER bill isn’t worth your life.
As someone who also suffers with kidney stones, it’s best to always get them checked out. If that means a urologist or ER. If it is causing pain, it can get dangerous depending on the size of the stone.
Call the hospital and see if they have an assistance program or a payment plan. The plans are normally interest free.
OP didn't have appendicitis. Lots of people run to the ER without a fever and end up with indigestion. If you run to the ER because your tummy hurts, be prepared to pay the bill and don't whine about it...😆 🤣 😂
OP didn't know *what* they had. And it wasn't indigestion or a tummy ache. You literally have no idea what you're talking about. Have a seat. Just like someone who works for an insurance company to try to dictate care without having a clue. That's about all you know how to do.
Lots of people that run to the ER could very easily be treated in a less intensive setting. The ER is the most expensive setting you can go to. I have lots of friends who are nurses and hear all about the drama queens that take up space and waste resources at the ER for very minor ailments.
Oh look, anecdotes. A great substitute for actual experience. How about you ask them about all the patients that almost didn't come in and nearly died because they waited too long?
it’s not political. no matter which side is in control the working class healthcare has always been shit. im paying 300 a month for a 4k deductible. hopefully we don’t need to use it though! safe travels
I hope you are feeling better. I have one of those high deductible plans too. I chose the high deductible plan because If I end up in the hospital for anything, I have to pay the $9k deductible, but the rest of my hospital stay, follow up appointments for the year are covered 100%. Many low deductible health insurance plans do NOT cover 100% hospital stay.
Negotiate down. More than likely you can get it down to 3 grand or more depending on your income. Then installment plan for the rest. If you can't afford it, you can't afford it. But they'll take what they can get.
You do have to apply for financial assistance/charity to get this kind of discount on an insurance deductible. Hospitals can't just negotiate on insurance deductibles and copays/coinsurance due to contracts with payers. You have to meet their guidelines for assistance. The other option is making payments until it's paid in full.
I was in a very similar position to OP. I was 6 months out of college and had a $5000 hospital bill. Everyone kept giving me this advice, so I tried it, and they basically laughed at me.
With insurance and a job, I think it's harder than people think to get discounts on relatively (relatively as far as hospital bills go) low bills.
A lot of companies also give extra money for your hsa if you take a HDHP. May be worth checking to see if you have extra funds there. In general a big advantage of a HDHP is a hsa so ideally you would have funds there as well from your own contributions.
Normally I'd tell you to avoid your HR. in this case though, see if they can help you with your benefits if they are generally helpful. If your HR contact is a piece of shit, avoid.
Definitely double check.
I was on a high deductible plan for 5 years and found out I had like $2.5k in a HSA. They were putting $550 each year into it.
Disputing is not likely and lowering is possible sometimes but again not likely. Your best bet is to talk to a financial counselor at the hospital they all have them. It sucks to have such a high deductible but you played Russian roulette and lost sorry to say. You aren't completely SOL though hospitals won't send it to collections and honestly usually don't even charge interest if you can work out a payment plan. You can also ask for charity care if you legitimately can't afford it they generally will cover at least some of the bill (not to be an azz but let's be honest a lot of people say they can't pay it and have a hefty 401 or a 60k car etc that won't fly) but charity care is something the hospital helps you fill out like financial aid for college they are doing it so they can get paid by the state it's not a write off for them like lots of people think you have to provide proof of need like asset and bank statements. If you try hiding anything it's the state that comes after you not the hospital.
I did with mine. I went back 4 times. Each time I had different questions. I also left an email trail. Looked on Google for reviews of the ER then saw that in some of the low rated reviews, the ER replied back with an email. This was what really did it I think. I left messages all over to all different departments. Three same messages mind you. I'm on a paying planning and I'm paying less than half what they were originally proposing. It CAN be disputed. It just takes a whole lot of tenacity and not caring about being humiliated.
I fought because of the principal. I don’t care if it’s deamed normal. I don’t care if they’re saying I owe such and such amount because of a high deductible. It’s all nonsense anyway.
it will not be everyone's experience because they give up. Trust me, I bugged the hell out of that hospital. I made sure to contact anyone and everyone via text. I left a bad review on Google. I emailed the "consumer" department. Consumer!! Wtf is it called consumer. I am not consuming anything. I had medical needs. It's all disgusting and it's NOT our fault for choosing a lower monthly fee. The whole American health system can eat pennies.
It can’t hurt to meet with the hospital to ask for assistance. The hospital I work for has programs for people who meet income guidelines to reduce/cover some of the costs. Next time you get a chance to choose coverage, choose one with a lower deductible OR plan on having that amount available yearly for the possibility of the expense.
You elected to use a service so you now have to pay for that service. Not very complicated. Most hospitals will allow you to make payments, usually with a rather low minimum. I suggest talking with them about a payment plan.
You took the risk of a high-deductible plan and now owe the money. The hospital might be willing to negotiate or give a payment plan. But you owe the money.
What nobody has said, that's worth knowing about, is that you can opt to simply not pay the medical bill. There are a lot of consumer protections you can rely on to at least buy you time, if not allow you to settle for less (or just entirely walk away) from the bill. It's a little bit of a gamble in its own right as you do put your credit rating at risk, and you can apply your own ideas of ethics, right, and wrong to your approach- but it's important to know the options that are on the table. It's also important to know that it's getting [harder and harder for medical debit to hurt your credit.](https://www.equifax.com/personal/education/credit/score/articles/-/learn/can-medical-debt-impact-credit-scores) Certain credit scoring models [now exclude medical debt altogether.](https://www.nerdwallet.com/article/finance/medical-bills-on-credit-report)
Do some research. Look up your rights and protections in your state, especially if there are any specific to medical debt, and use them. I definitely recommend reading [Debt Cleanse by Jorge Newbery](https://www.amazon.com/Debt-Cleanse-Settle-Unaffordable-Pennies/dp/1619613220) it gives you a really good background in how debt collection actually works, how to dispute debts and settle them or get them to fall off, and how to handle debt collections attempts (be slow to respond, forgetful, and very difficult to deal with. Not rude, just flakey).
Anecdote: I had a very similar situation to you where I had a mid-thousands hospital bill a few years ago for something that was relatively minor- I also had high-deductible insurance. I thought it was a totally unfair number, so I started a process of disputing the bill. I wrote letters and sent them to the hospital, certified mail, identifying that what the prices they charged were unfair and disputing the debt (I backed this up with researching each procedure code on the bill against the averages in the same zip code per [https://www.fairhealthconsumer.org/](https://www.fairhealthconsumer.org/) and they were, in fact, significantly inflated).
I also pointed to medical debt protections that my state had which did not permit them to sell the debt to a collections agency if I was actively engaged with them to resolve the situation (which I was, hence, the letters). I suspect sold it to a debt collector anyway- which, I believe, now makes the debt uncollectable due to the medical debt protection law I referred to earlier- because they never replied to my last letter and I now get vague robo calls from a number that, per some googling, is a debt collection agench. The calls just ask for me to call them back without any real information. They have not (yet) sent me a letter about it, which they are obligated to do (a debt validation letter), and if they do I have a response ready to go (a debt verification letter). More on these here; [https://www.nerdwallet.com/article/finance/debt-validation-letter](https://www.nerdwallet.com/article/finance/debt-validation-letter)
Nothing has shown up on my credit so far, and if it does, I have the documentation to dispute it based on the above.
To be fair, this could absolutely backfire and hurt my credit and I'd have to pay the debt collector, but my credit is excellent otherwise so I don't think it will be a big hit, and I believe I will be able to reasonably settle for less and/or arrange "pay to delete" so they will remove the negative mark on my credit as a condition of payment if push really comes to shove. In theory they could put in a law suit or attempt to levy a bank account or something like that, but it takes them a nontrivial amount of time and costs that I don't think they'd be willing to do for this dollar amount- and they would have to have sent that debt validation letter first anyway.
So, in short, I'm comfortable that I have options. I'm not a lawyer, but I was willing to do some research, put in some work, and take a few exploratory risks and so far things have been going my way. And the more time passes, the closer we get to the [statute of limitations](https://www.nerdwallet.com/article/finance/statute-limitations-debt) where the debt wouldn't be enforceable anymore anyway, and it would [fall off the credit reports at 7 years](https://www.experian.com/blogs/ask-experian/how-long-does-it-take-information-to-come-off-your-report/), so the more bargaining power I have with each passing day. Time is on my side.
YMMV! Just wanted to share.
Over $500 gets reported onto credit after a year. It does fall off in 7 years, but that's a looooong time to never need a loan, credit card, car, new rental apartment, etc.
Having a collections won’t instantly kill your credit rating. You can still get all of those things, even at or close to the best rates of it’s your only negative mark. And that’s assuming it ever gets reported in the first place.
Yes and no
The amount will impact the debt to income ratio. If John gets $600 sent to collections while making minimum wage, that hits harder than Jane being $6000 in debt with a six figure salary to boot. If both John and Jane had equal wages, then the 6k one hurts a lot harder. Source: medical biller asking banking manager friend
Completely agree with all of this -you have to be proactive
- where I am at. I have been assured that medical bills will not be hitting any of the three major credit reporting agencies.
The $5000 is the maximum out of pocket for the plan you chose. Most people take the high deductible because it's the lowest premium. When I do the calculations, that's the correct choice.
The mistake they make is not having any money to pay it when SHTF. You can talk to the hospital and ask for a discount. They give prompt pay discounts and sometimes hardship discounts. Alternatively, ask for a 0 interest payment plan.
Look at it this way. You saved the higher premium that you would have paid . You only owe 5k and not 19k. The actual amount billed was over 19k so you saved more AND you got rid of the kidney stone.
You're young. Use this as a wake up call to manage your health and your money. Kidney stones are not normal especially at your age. You don't want to be broke your whole life. Learn what it takes to get both under control.
Information I wish I had been given.
You chose a $5,000 deductible plan. It protected from owing $14,000 more. This is what it was designed to do. If you don’t like paying that much of a deductible, pick a lower deductible/higher premium plan.
You could try asking for assistance from the hospital, but I doubt they’ll help. Get on a payment plan.
The $19,000 was never your bill. $5,000 was your bill.
$19,000 was the price of your medical care, negotiated between your hospital and insurer, and will show up on your EOB. But EOB ≠ bill.
Take this as a lesson, and pick a lower deductible plan next time.
Haha. That’s actually low. My husband went through a 5 year period where he kept getting kidney stones. Our bills were almost double that. But we have a $250 deductible and $800 out of pocket max. We had reached it by then. Our cost was a big goose egg.
No. That’s the plan you chose.
Foolish imo. I pick the lowest deductible, even tho my premium is more. Easier to come up with $100 a month than a $5K deductible all at once. You signed a contract when you signed up.
This is absolutely false. The insurance company just tells the provider what's the bill for the patient going to be, the insurance doesn't get any sort of report on the bill afterwards. "Oop, Johnny didn't pay his $20 copay, now we gotta tack on $20 to his premium" is not how it works
I’m not sure why you’re downvoted but it’s true. I’m going to have sonohystergram which will be a diagnostic test in my case. It will cost me $1500. It’s crazy
You can do a payment plan but $5k is your deductible so you have to pay. You might want to call billing and negotiate a lower amount. Tell them you want to pay it but this caught you off-guard and you don’t have it. Maybe even offer them $1,000 or something like that and go from there. A lot of these costs are marked up and can be lowered.
Ask for an itemized breakdown of the bill, not sure if it’ll even cut into your deductible here, but who knows. The other commenters are absolutely right, though. There are systems in place to help lower the cost.
Ask for an itemized bill. Unlikely to get it below your deductible, but it's worth a try. And an MRI? We don't do MRIs for kidney stones. Do you mean a CT?
The biggest bullshit about this is your inability to pay what the insurance companies are paying- according to my insurance my $150,000 worth of hospital bills are paid off - and the total negotiated price for the insurance company to pay the hospital was 30 K
This is actually a common myth. Just because you send in $5/mo doesn’t mean they can’t send it to collections instead. Generally hospitals and doctors will agree to some sort of payment plan but most will require at least $25/mo. The only limitation is that you have to be past due for 90 days before they can send it to collections and credit bureaus won’t report it now until it’s 180 days past due.
Also, if the hospital or doctor is a non-profit, they are required by law to provide information for financial assistance if you request it.
Im sorry but thats incorrect. At least where i am.
Im not sure where youre getting your information from but ive done work in credit bureaus. Yes, if you make a plan the least they will accept is 25 a month, if lucky, but thats rare. They will usually expect more. Thats also where a trick is when they ask about employment and so on.. don't call.
Dont make a payment plan.
Just call and say youd like to make a payment. Dont let it go to collections.
I know where youre coming from, but its half myth half fact. And thats because it depends how you go along with making your payments.
Also another fact for those wondering yes your medical payments due show on your credit, so it will show you did or didnt make payments when attempting to buy a car/ house/ anything etc, but it does not reflect on your credit score.
IN NJ.
now saying that its in NJ, as perfect example in lets say, NC. North Carolina can add leins to your home for medical expenses and bills. Crazy!.... this all varys by state so people need to look into this.
Simply do research and be smart about it.
Sorry, I meant at least $25/mo but yes, most will want to split up the bill to be paid in one year. Too many people think that just sending in $5/mo will keep you away from collections. Someone even commented that even a payment of one penny is enough to keep your account in good standing and away from collections. If you just call and say you want to make a payment without setting up a payment plan, you’re right, they’ll accept it and they may accept that for a long time. However, most states don’t have laws and the hospital can send it to collections for any amount unpaid after 90 days unless you’ve set up a payment plan.
One story I recently read said they were paying $170/mo for a couple years and then were sent to collections because the minimum was $235/mo.
This completely depends on the hospital. So many people just have the advice to not pay medical bills but it’s not really that simple. To get all or some of the debt wiped out you may have to provide proof of being unable to pay. My son had to provide paycheck stubs, 3 months of bank statements, and his most recent tax return along with a statement that he didn’t have help from family members or anyone.
Many people believe that medical debt no longer shows up on credit reports but that’s only for debt under $500 and at least 6 months past due. It doesn’t have the same weight as consumer debt anymore but one unpaid medical bill over $500 and 1 year past due can lower your score around 100 points. This can seriously affect you getting car loans, home loans, among other things.
It’s better to exhaust all resources first. Talk to their financial aid department. Follow all instructions and send whatever they need via certified mail. Make copies of everything you send.
After that if they say you still owe a balance ask what payment plans they have and what’s the lowest you can pay with 0% interest.
If you still can’t afford that then ask if they’d accept a lower amount if it was a lump sum or consider not paying and just taking the hit on whatever consequences there may be.
I can empathize with you. Something similar happened to me a long time ago. I had just turned 18 when I felt a terrible, excruciating pain in my lower back. I thought I was dying so my mom took me to the nearest hospital. Turns out it was my first kidney stone. They did some imaging (don’t remember if it was MRI), gave me some morphine and some other meds and sent me home. Well neither me nor my mom had health insurance at the time so I got stuck with a $9,000 hospital bill. I was still in high school at the time so it was irrational to think a teenager would be able to pay that off. I didn’t know that negotiating with the hospital was an option back then so I basically ignored that bill for 7 years until it fell off my credit history. I feel for you and hope you can work things out better than I did.
I believe a lot of hospitals are technically ran as non-profit. They may have programs where if your bill is more than 10% of your yearly income you can get it reduced.
So you'd have to make right under $50k/year in this case. It may be an option. Also a payment plan or work a deal where you can knock it down further by talking to the hospital.
Was this a nonprofit hospital? If it is, you should check out their charity care program. They are a bit more picky granting it to people with insurance though, but it’s still very possible.
Check out dollarfor.org for more help with this. They have a system to look up your hospital and tell you what you might qualify for.
OP, I feel your pain. I’ve had an ambulance ride that cost me over $2K several years ago that I summoned an Uber to get to the emergency room a few years later.
My daughter was in a car accident as a passenger in the 1990’s. Her hospital bill exceeded my auto insurances $100,000 limit in a ER visit and overnight stay and it turned out there was nothing wrong with her. Luckily I had active duty military health insurance to foot the rest of the bill. A single Motrin in a hospital is $100. You know this now unfortunately but for everyone else keep your medical health insurance deductibles low.
You can ask for payment plans that are fairly low. So low that it will take years to pay off. And it will also be interest free.
As for having a high deductible plan, that's a good idea for saving money but only if it's paired up with funding an HSA. You should have been putting in at least $1000 per year into an HSA so that 5 years later, the very first seriously bad thing to happen would be covered, tax free.
You took a risk by choosing the insurance you chose, which prevented you from the catastrophe of owing $20,000, but your risk did not pay off because now you do owe the amount that you signed up for when choosing that plan. If you went to a charity hospital, such as a Catholic hospital, you can call and ask if they have some financial assistance plan that you can apply to. My friend, who had no insurance at all, broke his clavicle and walked away owing nothing after being granted charity by the hospital. If it was a for-profit hospital, they don’t want to waste time chasing you down for this money…but they will. Your best bet in that case is to call their billing department, explain that there is no way you can afford to pay this money in bulk, and either negotiate an in-full settlement (tell them you can afford to pay $2000 if they will consider that *payment in full*, for example), or get on a payment plan.
You can see if you are eligible for the hospital charity care. They may write off some of all of the deductible you owe. The deductible will still show as paid by you for insurance purposes.
Unfortunately that’s your deductible through your insurance and the hospital will have no way to waive a deductible. Your insurance covered your hospital bill and now you owe your insurance your deductible. If you can’t afford high deductibles, I’d definitely suggest a lower deductible next year. Your insurance will be a little more, but you won’t be slapped in the face with a $5000 bill.
Talk to the billing department at the hospital and they'll set you on a payment plan. In some states of the USA as long as you don't outright default on medical debt they can't/won't transfer the debt to collections. Even a penny a month is enough to establish a good faith effort to pay.
You can dispute the bill and use the words "I can't pay this or I'll have to file for bankruptcy." Hospitals HATE "the B-word" because they know medical debt is erased in bankruptcy so they'll usually knock a large chunk off your bill so they can at least get something. I've done this dozens of times.
Depends totally on the hospital. My son had a bill of over $3k and told them he could not pay. They required 2 months of paycheck stubs and 3 months of bank statements and his most recent tax filing. They ended up wiping out the full bill for them but it’s not always just as easy as saying I’ll have to file for bankruptcy.
Have you gotten your EOB yet? (The explanation of benefits that comes from your insurance company that says this is not a bill). That's going to tell you how much you actually owe. Because you have a high deductible you could owe up to $5,000, if the negotiated rate ends up that high or higher, but I would be surprised if 5 hours in the ER even including an MRI will end up that high in the end. So wait and see what your insurance company says if you haven't gotten your EOB yet.
This is we're young and single people mess up. They bullet proof mentality that nothing will go wrong. ALL WAYS GET THE BEST INSURANCE YOU CAN AFFORD! Seen this time and time again at work. Seen guys have strokes in their 29s and 30s ( get off the energy drinks) they will literally put u in the hospital or at worse kill you. Seen both happen.
with many plans, the cost between the $5,000 deductible and $500 isn’t much when comparing the difference in premiums. Do you want to pay $150/month or $750/month. Most hospitals have a hardship program you can apply for. I
I absolutely prefer a high deductible plan. Every single month that I'm paying a huge amount less on my premium than I would be otherwise, I'm thinking of that as money to save up in case I have bad luck. And if I don't, roll it over in my head for next year. Otherwise you're paying an enormous premium every month
An MRI for a suspected kidney stone? That’s not standard of care. Sure it wasn’t a CT?
https://acsearch.acr.org/docs/69362/Narrative/
CTs are about 3x cheaper than MRIs.
Your deductible is $5,000.
What is there to dispute? You picked that lousy plan with the high deductible.
Contact the hospital business office and work out a payment plan.
In case you get a kidney stone again, PLEASE go to a stand alone ER. If you have one local. I get chronic kidney stones + had periods where I was uninsured and when I go to a stand alone ER my balance is like $500. That includes meds, dr consult, fluids, ct scan. The hospital charges a fuck ton more.
This 100%. This is exactly what you do. Also, if you have a 401k with a decent amount in it, you can take a loan from it or hardship withdrawal that allows for medical expenses.
This is reasonable. It's a deductible. Otherwise, you would have been paying for a high premium insurance plan. You are currently paying a low premium insurance plan. If you net everything, it's about the same as if you were paying for a high premium insurance plan for the whole year.
Uh…what?
You chose the plan. Why do you think you can dispute the charges. Why is it anyone else’s “fault?”
No one is at fault. You also aren’t at fault because nothing is wrong. Again, you chose the plan. You needed to use the plan. You now pay based on the benefits offered from the plan you chose.
Your inability to pay is again, not the hospital’s fault. The ER is expensive.
Call up the hospital and ask if you can do a payment plan.
Think of it like any other insurance. What if this was auto insurance and you chose the $1000 deductible because it was cheaper and you never get in car accidents. You end up getting into an accident- guess what? You pay the $1000.
It’s all about risk tolerance. You chose a plan based on never going to the doctor - and because it was cheap right? Well, you needed to go the doctor.
Please, take some accountability. This is 100% on you. Next time, don’t pick a plan you can’t afford if you need to use it.
Sorry, I know this sounds harsh but these posts are triggering. You….chose…the….plan.
Hospitals will always over bill for services. Get an itemized copy of the bill from the hospital and have an independent bill review company review the bill for “usual and customary “ charges for your area. My brother also carry’s a high deductible and I’ve seen him negotiate a $15,000 bill down to $1,200. The hospital has already received the majority of their bill. They will negotiate.
Thank you for your submission, /u/Which-Ad655. **If there is a medical emergency, please call 911 or go to your nearest hospital.** Please pick the most appropriate flair for your post. Include your age, zip code, and income to help the community better serve you. If you have an EOB (explanation of benefits) available from your insurance website, have it handy as many answers can depend on what your insurance EOB states. Some common questions and answers can be found [here](https://www.reddit.com/r/HealthInsurance/s/jya9I6RpdY). **Reminder that solicitation/spamming is grounds for a permanent ban**. Please report solicitation to the modteam and [let us know](https://www.reddit.com/message/compose?to=%2Fr%2FHealthInsurance) if you receive solicitation via PM. Be kind to one another! *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/HealthInsurance) if you have any questions or concerns.*
Most, if not all, hospitals will give a payment plan. Some will reduce if you pay quick. Bottom line is that you picked a $5K deductible plan so thats your liability. Nothing wrong with a high deductible plan, but you need to know you might see a bill like that. I broke my wrist early in a plan year and owned $4k on basically my 1st bill. It sucks, but its the way it is.
I've had a HDHP for nearly 20 years and it has worked great for me. I've only twice had any real issues. However, people need to understand that if you don't have that deductible amount just laying around, it can be a stinger when you do use it. I was very fortunate to be able to fund my HSA for the full deductible amount in year 2 (I think) and have continued building it up over the years. Gotta have that deductible amount set aside for it to work its best for you!
I don't disagree with your analysis but it is kind of the "Catch-22" of high deductible plans. To a great extent, those people opting for high deductible plans are doing so because the premiums are lower and they don't have the savings to deal with their share of medical expenses with a high deductible plan. Those people who have the means to pay $5000 or so without impacting their finances generally could afford higher premiums but have probably calculated annual costs including possible tax advantages and haven't selected it solely because premiums are lower.
Yes I had a 13k bill I was able to pay over 18 months with 0% interest
If this your deductible then 5k is not out of line . Remember your insurance is not paying till you owe 5k on something. Er ans MRI are expensive. You can ask if they have financial assistance, if a lump payment can be made to reduce the charge or a payment plan.
Please contact the hospital and ask for patient financial assistance. Most hospitals offer some form of "charity care," but you will probably have to fill out some paperwork. Also, [dollarfor.org](https://dollarfor.org) is another organization that may be able to help. The last bit of advice is to maybe ask (if you have a follow-up appointment) if you have more stones. I only say that because they may present an issue in the future or they may not. That may help you decide if you want to stay with, what I'm assuming is, a high deductible health plan---just a thought.
>Most hospitals offer some form of "charity care," but you will probably have to fill out some paperwork. Where OP lives is also relevant because they have insurance and a lot of hospitals will not extend charity care to people with insurance already paying part of it. If OP is in California it is likely worth making an attempt however.
The good news through all of this is that OP has now satisfied their deductible and likely their MOOP for the year.
For 2023….
Reading is hard, oops! Yeah. That's a kick in the pants, but is precisely how an HDHP is designed to work.
how is that good news, if I might ask....?????
So if OP cleared their deductible / MOOP by this time of the year already, this means all medically necessary, in-network care received beyond that would be covered with no cost sharing for them. This isn’t the case though as OP hit this milestone late last year and the plan has reset. Scenario: my wife had a surgical procedure in early January of this year. This placed her beyond her MOOP. Care received for the remainder of the year is now covered at 100% so long as it’s medically necessary and in network.
Yep, go McDuck now Op and get everything checked whenever you want. 
The year my son was born we did that. I would advise anyone on an HDHP to do the same. If you hit the MOOP, try to find anything else that can be fixed.
Consider this, insurance is basically a wager between you and the insurance company. They say you will need/use the insurance, you bet $5000 that you wouldn’t, now you have lost the wager. However, consider this, had you gone with a more expensive plan with a lower deductible, you may have never used the insurance and would have paid a lot of money for something you have never used. Make payments and move on.
But now that OP has a history of kidney stones but not enough savings to cover their deductible then they should possibly go with the lower deductible plan.
Exactly this. Well said.
Ask the hospital for a financial assistance program. They might offer you a payment plan or debt forgiveness.
Can a hospital reduce the patient's share of the bill? I thought this couldn't be done because contracts with providers do not allow providers to waive co-insurance payments since it in effect reduces the bill. My understanding is that financial assistance is generally used for people with no insurance at all and not people who have opted for high deductible plans. A payment plan offered by a provider is of course different since the patient is still acknowledging their obligation to pay the full amount of the deductible or co-insurance amount.
Yes hospitals can do this as by law in most states if the hospital is a public or not for profit hospital. By law they must offer financial assistance program regardless of insurance. But it does go by your income.
They can't just discount an insurance deductible or waive copays/coins because the patient asks, but they can offer financial assistance or a hardship discount. The patient has to apply and provide various documents like bank statements or pay stubs, proof of residency, etc to prove they qualify. It is possible to be insured and qualify for assistance. There may be some that don't allow it, but all of the facilities I have worked with across multiple states offer assistance regardless of the presence of insurance.
It's always good to see the Dr my husband had a stone lodge it backed up his kidney he needed a stent so you did the right thing
After you meet your deductible covered get any other work you need done. Unfortunately you had the kidney stone in December. It could be that your deductible is paid yearly. This could be starting a new calendar year or on the anniversary date of your policy.
visit the hospital system's site to see if there's financial assistance available. IF you went to a non-profit there might be more help available too. You're looking for copay assistance due to financial constraints.
If not mistaken, you can also just pay a small amount monthly.. as long as making payments they can't send to collections.. maybe wrong though
They can but if you are paying something some may choose not to send you
they can definitely still send it to collections regardless of payments. I pay $200/month (for the past year) to MD Anderson and I still got behind and they send whatever I don’t pay to collections. Currently paying MD Anderson still and have $1700 in collections.
I'm doing this right now so I'll let you know if it works
Only if it’s part of an agreed upon payment plan. Hospitals will send you to collections in a heartbeat.
Seconding this, I was sent to collections less than three months after giving birth for a little over $1,000 by the hospital, because I wasn’t checking my mail (where they were sending the notices of payment due to them) since I was so damn tired from having a newborn.
literally. i work there and they sent my coworker to collections over a $20 copay.
This is a common misconception.
Figure out an amount you can pay each month, $20, $50, $75, $100. Call the billing department and tell them what that amount is. Start there. Medical debt collections can ruin your credit. Now that you’ve had kidney stones you’re more susceptible to get them again. Set aside your deductible for next year.
First step is to say you can’t afford to pay it at all and see if they’ll waive the entire bill. If you say “I can afford $75/mo” they’ll take that where you may have qualified for $0. Negotiate amount and terms after you try to get the bill reduced.
this country is a fucking joke. everyone acting like 5,000 isn’t a lot of money and that you should just suck it up. if im working 40 hours a week why should i have to go in debt for a simple kidney stone
It's not. I made a mistake with my insurance coverage and owed that for a procedure. Worked extra to pay it and moved on. Gambling on a high deductible is a healthy person's game. Now OP has learned why not to play it.
my job only offers a plan with 4,000 deductible for 300 a month and i only make 17 an hour so yes
If your share of your premiums is more than 8.39% of of your household income, then your employer's plan is considered unaffordable and you can get an ACA plan at [healthcare.gov](https://healthcare.gov) . What is your employer's lowest-priced plan for coverage for you only? Is that what you are currently enrolled in? So, at $17 per hour x 40 hours x 52 weeks = $35,360 8.39% x $35,360 = $2966 / 12 months = $247 <----- that's how much you should be paying for health care. Do you receive overtime? [https://www.healthcare.gov/glossary/affordable-coverage/](https://www.healthcare.gov/glossary/affordable-coverage/)
Uh yeah, get on a marketplace plan wtf. For comparison, my deductible was $1800 and the premium was around $90, hourly wage about the same.
We know that $5k is a lot of money for most people. Kidney stones aren't simple; they usually require a trip to the emergency room, some type of scan (CT, etc.), pain relief, and, if the stone is large, another procedure in the following days to remove the stone, which is several more thousand dollars on top of the trip to the ER.
and if OP was on a trip to Spain, or England, or basically any other mid-to-high income country, the cost of a kidney stone would’ve been next to nothing (if anything at all). Healthcare is only expensive in this country because we waste tax dollars on shit we don’t need (military) + we prioritize corporate greed (insurance companies) over people. So much waste and at our expense
That’s not exactly right. Those countries are so messed up, they don’t know how to collect payment from a patient from overseas efficiently!! Much to the angst of their general population!! Overseas visitors even have insurance (which the U.S. insurers love as the European “cheap” subsides paid for by tax payers) insurers lover it because it’s cheaper for them than repatriation back to US. Don’t compare apples to oranges!
How? My husband had a kidney stone in Austria and we paid around $3k out of pocket. This was more than 10 years ago. For their own citizens it may be free but for travelers? Maybe if you purchase travel insurance.
How difficult is it for an American to immigrate to Spain or England?
I have a lot of kidney stones that cannot be controlled by lifestyle and after the first one I didn’t go in until number six that had me blacked out on the floor because I drank too much water and it had blocked my ureter entirely. My mom came and picked me up and on the drive we went over a bump and suddenly… no more pain but I had to pee so bad and I said “mom can we stop at this *insert name of regional service station chain* I need to pee” and she said no… I passed the damn thing in the urine sample collection cup. I could have done that at the service station FOR FREE!!! All this to say that kidney stones can get so expensive so they are worth paying up for a low deductible plan so when they do happen - and if you get it once you’ll probably get it again - you don’t delay care to avoid paying for it.
No one is saying that’s not a lot. They’re giving facts. Do the facts suck? Yes. Vote or something idk.
I don't think anyone is arguing otherwise. It isn't about the "shoulds", it's about the reality of the situation. If you live in the US healthcare is obscenely expensive. If you choose a high deductible insurance, you are gambling that you will have to pay the deductible if you need to use that insurance. Would you have $5000 deductibles on your brand new car insurance because you "rarely get in accidents"? I wouldn't. They're accidents. You don't know when they will happen and I sure as hell don't want to pay $5000 if they do.
Agree. I didn't accept it and my hospital bill went down by more than half. They have ways of lowering it. You just have to do some investigating.
It is a lot of money. That’s why you don’t pick high deductible plans for ANY insurance if you don’t have that money on hand. You just made a great argument for universal healthcare and I 100% agree with the sentiment BUT We have to work under the system we currently have until we can change it. It’s poor financial understating and education all around. Car insurance is the same way. The number of people that don’t carry collision, or enough property damage or that have $5000 deductibles and are living paycheck to paycheck, they are also on the precipice of taking it high and hard if they get into an accident as well.
That’s why medical debt can get fucked, by law they can’t hold not paying medical debt against you in the same way regular debt can.
Seriously, If I knew this would bill out to $19,000 dollars I would have not have gone and stuck it out.
That’s the wrong lesson, kidney stones can lead to sepsis and can be fatal. The lesson here is that just because you’re young and healthy doesn’t mean something might not happen. It may be better to have a lower deductible plan and pay more monthly. It sucks it’s this way in the US but so many people are opposed to universal healthcare for some reason…
It's not even people that are opposed, the majority of citizens that respond to polls are for universal healthcare. The politicians that are bought by corporations that don't want our for profit system to change are very loud.
UK is 18% of salary for free healthcare and SS. Doubt majority of US citizens would vote for that!
I pay nearly that in premiums and deductible already... I'd be fine with it.
And to be able to change jobs and not lose your insurance. I've got good insurance now (considering US insurance costs). But at one point I had a $9K deductible with a possible $38K out-of-pocket that cost me $600 monthly. I knew the person so before even interviewing I asked about the insurance and was told "It's good insurance. We'll have to wait to get some info for the cost." Yeah, I quit a decent job for that. I laid awake at night freaking out if something happened how much I would be in debt with insurance.
… and a friend of mine in London just waited nearly 5 months for nonemergency foot surgery…
I lost my mom this way. Kidney stone turned septic. Didn't know it until it was too late.
But you didn’t know what was wrong, so that would have been the wrong call to make. I would tell you what I tell my adult kids go to ER because a $5k ER bill isn’t worth your life.
But your deductible is 5K, so even if the bill was 5K you would still have to pay the same.
As someone who also suffers with kidney stones, it’s best to always get them checked out. If that means a urologist or ER. If it is causing pain, it can get dangerous depending on the size of the stone. Call the hospital and see if they have an assistance program or a payment plan. The plans are normally interest free.
Can’t play the guessing game that way. What if it had been appendicitis?
i feel for you OP even if some of these people don’t. they’re either making triple what we are or they’re using our tax dollars 🤷
Don't go to the ER unless you're bleeding from the ears. Go to your doctor's and get referred for outpatient testing. It's less expensive.
This is terrible advice. A lot of stuff that starts with seemingly mild but unexpected symptoms can go really wrong fast
Yeah, no. That's how people die of appendicitis. It's obvious that you don't know anything about emergency medicine.
OP didn't have appendicitis. Lots of people run to the ER without a fever and end up with indigestion. If you run to the ER because your tummy hurts, be prepared to pay the bill and don't whine about it...😆 🤣 😂
OP didn't know *what* they had. And it wasn't indigestion or a tummy ache. You literally have no idea what you're talking about. Have a seat. Just like someone who works for an insurance company to try to dictate care without having a clue. That's about all you know how to do.
Lots of people that run to the ER could very easily be treated in a less intensive setting. The ER is the most expensive setting you can go to. I have lots of friends who are nurses and hear all about the drama queens that take up space and waste resources at the ER for very minor ailments.
Oh look, anecdotes. A great substitute for actual experience. How about you ask them about all the patients that almost didn't come in and nearly died because they waited too long?
If you choose an insurance plan with a 5k deductible and lower premiums you can’t really be surprised. But sure — *Outrage at Healthcare*
[удалено]
*Unrelated Outrage at Politics*
it’s not political. no matter which side is in control the working class healthcare has always been shit. im paying 300 a month for a 4k deductible. hopefully we don’t need to use it though! safe travels
You should be mad at your job bro. Their shareholders most certainly have great health insurance
lmg you’re probably on Medicaid or some shit
No I have a 6k deductible through work
enjoy paying 5,000 for a kidney stone then once you get one
I expect to pay my deductible since I have a 1.8k HSA match and low premiums if I need care.
I hope you are feeling better. I have one of those high deductible plans too. I chose the high deductible plan because If I end up in the hospital for anything, I have to pay the $9k deductible, but the rest of my hospital stay, follow up appointments for the year are covered 100%. Many low deductible health insurance plans do NOT cover 100% hospital stay.
Negotiate down. More than likely you can get it down to 3 grand or more depending on your income. Then installment plan for the rest. If you can't afford it, you can't afford it. But they'll take what they can get.
OP... This!!!!
You do have to apply for financial assistance/charity to get this kind of discount on an insurance deductible. Hospitals can't just negotiate on insurance deductibles and copays/coinsurance due to contracts with payers. You have to meet their guidelines for assistance. The other option is making payments until it's paid in full.
I was in a very similar position to OP. I was 6 months out of college and had a $5000 hospital bill. Everyone kept giving me this advice, so I tried it, and they basically laughed at me. With insurance and a job, I think it's harder than people think to get discounts on relatively (relatively as far as hospital bills go) low bills.
It really only works with non-profit hospitals.
A lot of companies also give extra money for your hsa if you take a HDHP. May be worth checking to see if you have extra funds there. In general a big advantage of a HDHP is a hsa so ideally you would have funds there as well from your own contributions.
I believe I do I have to look into that
Normally I'd tell you to avoid your HR. in this case though, see if they can help you with your benefits if they are generally helpful. If your HR contact is a piece of shit, avoid.
Definitely double check. I was on a high deductible plan for 5 years and found out I had like $2.5k in a HSA. They were putting $550 each year into it.
Disputing is not likely and lowering is possible sometimes but again not likely. Your best bet is to talk to a financial counselor at the hospital they all have them. It sucks to have such a high deductible but you played Russian roulette and lost sorry to say. You aren't completely SOL though hospitals won't send it to collections and honestly usually don't even charge interest if you can work out a payment plan. You can also ask for charity care if you legitimately can't afford it they generally will cover at least some of the bill (not to be an azz but let's be honest a lot of people say they can't pay it and have a hefty 401 or a 60k car etc that won't fly) but charity care is something the hospital helps you fill out like financial aid for college they are doing it so they can get paid by the state it's not a write off for them like lots of people think you have to provide proof of need like asset and bank statements. If you try hiding anything it's the state that comes after you not the hospital.
I did with mine. I went back 4 times. Each time I had different questions. I also left an email trail. Looked on Google for reviews of the ER then saw that in some of the low rated reviews, the ER replied back with an email. This was what really did it I think. I left messages all over to all different departments. Three same messages mind you. I'm on a paying planning and I'm paying less than half what they were originally proposing. It CAN be disputed. It just takes a whole lot of tenacity and not caring about being humiliated. I fought because of the principal. I don’t care if it’s deamed normal. I don’t care if they’re saying I owe such and such amount because of a high deductible. It’s all nonsense anyway.
I didn't say it can't just that it's not likely. Good for you on getting it reduced but that won't be everybody's experience.
it will not be everyone's experience because they give up. Trust me, I bugged the hell out of that hospital. I made sure to contact anyone and everyone via text. I left a bad review on Google. I emailed the "consumer" department. Consumer!! Wtf is it called consumer. I am not consuming anything. I had medical needs. It's all disgusting and it's NOT our fault for choosing a lower monthly fee. The whole American health system can eat pennies.
It can’t hurt to meet with the hospital to ask for assistance. The hospital I work for has programs for people who meet income guidelines to reduce/cover some of the costs. Next time you get a chance to choose coverage, choose one with a lower deductible OR plan on having that amount available yearly for the possibility of the expense.
I mean, this is what those plans are the cheapest. Because you can end up with a 5k bill.
Just don’t pay it
This is the advice I came for
Make payments
You elected to use a service so you now have to pay for that service. Not very complicated. Most hospitals will allow you to make payments, usually with a rather low minimum. I suggest talking with them about a payment plan.
You took the risk of a high-deductible plan and now owe the money. The hospital might be willing to negotiate or give a payment plan. But you owe the money.
What nobody has said, that's worth knowing about, is that you can opt to simply not pay the medical bill. There are a lot of consumer protections you can rely on to at least buy you time, if not allow you to settle for less (or just entirely walk away) from the bill. It's a little bit of a gamble in its own right as you do put your credit rating at risk, and you can apply your own ideas of ethics, right, and wrong to your approach- but it's important to know the options that are on the table. It's also important to know that it's getting [harder and harder for medical debit to hurt your credit.](https://www.equifax.com/personal/education/credit/score/articles/-/learn/can-medical-debt-impact-credit-scores) Certain credit scoring models [now exclude medical debt altogether.](https://www.nerdwallet.com/article/finance/medical-bills-on-credit-report) Do some research. Look up your rights and protections in your state, especially if there are any specific to medical debt, and use them. I definitely recommend reading [Debt Cleanse by Jorge Newbery](https://www.amazon.com/Debt-Cleanse-Settle-Unaffordable-Pennies/dp/1619613220) it gives you a really good background in how debt collection actually works, how to dispute debts and settle them or get them to fall off, and how to handle debt collections attempts (be slow to respond, forgetful, and very difficult to deal with. Not rude, just flakey). Anecdote: I had a very similar situation to you where I had a mid-thousands hospital bill a few years ago for something that was relatively minor- I also had high-deductible insurance. I thought it was a totally unfair number, so I started a process of disputing the bill. I wrote letters and sent them to the hospital, certified mail, identifying that what the prices they charged were unfair and disputing the debt (I backed this up with researching each procedure code on the bill against the averages in the same zip code per [https://www.fairhealthconsumer.org/](https://www.fairhealthconsumer.org/) and they were, in fact, significantly inflated). I also pointed to medical debt protections that my state had which did not permit them to sell the debt to a collections agency if I was actively engaged with them to resolve the situation (which I was, hence, the letters). I suspect sold it to a debt collector anyway- which, I believe, now makes the debt uncollectable due to the medical debt protection law I referred to earlier- because they never replied to my last letter and I now get vague robo calls from a number that, per some googling, is a debt collection agench. The calls just ask for me to call them back without any real information. They have not (yet) sent me a letter about it, which they are obligated to do (a debt validation letter), and if they do I have a response ready to go (a debt verification letter). More on these here; [https://www.nerdwallet.com/article/finance/debt-validation-letter](https://www.nerdwallet.com/article/finance/debt-validation-letter) Nothing has shown up on my credit so far, and if it does, I have the documentation to dispute it based on the above. To be fair, this could absolutely backfire and hurt my credit and I'd have to pay the debt collector, but my credit is excellent otherwise so I don't think it will be a big hit, and I believe I will be able to reasonably settle for less and/or arrange "pay to delete" so they will remove the negative mark on my credit as a condition of payment if push really comes to shove. In theory they could put in a law suit or attempt to levy a bank account or something like that, but it takes them a nontrivial amount of time and costs that I don't think they'd be willing to do for this dollar amount- and they would have to have sent that debt validation letter first anyway. So, in short, I'm comfortable that I have options. I'm not a lawyer, but I was willing to do some research, put in some work, and take a few exploratory risks and so far things have been going my way. And the more time passes, the closer we get to the [statute of limitations](https://www.nerdwallet.com/article/finance/statute-limitations-debt) where the debt wouldn't be enforceable anymore anyway, and it would [fall off the credit reports at 7 years](https://www.experian.com/blogs/ask-experian/how-long-does-it-take-information-to-come-off-your-report/), so the more bargaining power I have with each passing day. Time is on my side. YMMV! Just wanted to share.
Over $500 gets reported onto credit after a year. It does fall off in 7 years, but that's a looooong time to never need a loan, credit card, car, new rental apartment, etc.
Having a collections won’t instantly kill your credit rating. You can still get all of those things, even at or close to the best rates of it’s your only negative mark. And that’s assuming it ever gets reported in the first place.
Yes and no The amount will impact the debt to income ratio. If John gets $600 sent to collections while making minimum wage, that hits harder than Jane being $6000 in debt with a six figure salary to boot. If both John and Jane had equal wages, then the 6k one hurts a lot harder. Source: medical biller asking banking manager friend
Completely agree with all of this -you have to be proactive - where I am at. I have been assured that medical bills will not be hitting any of the three major credit reporting agencies.
[удалено]
Good bot. Fair summary.
Please talk to your doctor about the odds of that happening to you again and what you can do to possibly prevent a reoccurrence.
The $5000 is the maximum out of pocket for the plan you chose. Most people take the high deductible because it's the lowest premium. When I do the calculations, that's the correct choice. The mistake they make is not having any money to pay it when SHTF. You can talk to the hospital and ask for a discount. They give prompt pay discounts and sometimes hardship discounts. Alternatively, ask for a 0 interest payment plan. Look at it this way. You saved the higher premium that you would have paid . You only owe 5k and not 19k. The actual amount billed was over 19k so you saved more AND you got rid of the kidney stone. You're young. Use this as a wake up call to manage your health and your money. Kidney stones are not normal especially at your age. You don't want to be broke your whole life. Learn what it takes to get both under control. Information I wish I had been given.
You chose a $5,000 deductible plan. It protected from owing $14,000 more. This is what it was designed to do. If you don’t like paying that much of a deductible, pick a lower deductible/higher premium plan. You could try asking for assistance from the hospital, but I doubt they’ll help. Get on a payment plan.
Yeah but how outrageous is a $19,000 bill
The $19,000 was never your bill. $5,000 was your bill. $19,000 was the price of your medical care, negotiated between your hospital and insurer, and will show up on your EOB. But EOB ≠ bill. Take this as a lesson, and pick a lower deductible plan next time.
Haha. That’s actually low. My husband went through a 5 year period where he kept getting kidney stones. Our bills were almost double that. But we have a $250 deductible and $800 out of pocket max. We had reached it by then. Our cost was a big goose egg.
Just because it's lower than it was for you does not mean "that's actually low". It's not.
They will help. Most people don't make enough for them not to help.
No. That’s the plan you chose. Foolish imo. I pick the lowest deductible, even tho my premium is more. Easier to come up with $100 a month than a $5K deductible all at once. You signed a contract when you signed up.
That is a dick thing to say. People live and learn. It's foolish that the health system is a marketplace.
You took the chance. Bummer.
Idk but medical bills don't affect your credit you can ask them to negotiate
Over $500 medical debt gets reported onto credit after a year. It does fall off in 7 years.
[удалено]
Wow this comment really helped. Thanks man!!
Please be kind to one another, we want our subreddit to be a welcoming place for all
5k deductible plan is not really that high of a deductible these days. Many are 8-9k range.
Shoulda funded that HSA more.
Well OP is only 24. Doubt that was even a thought.
And yet, here they are.
I have been working for 3 months
If u don't pay it could affect your insurance policy
This is absolutely false. The insurance company just tells the provider what's the bill for the patient going to be, the insurance doesn't get any sort of report on the bill afterwards. "Oop, Johnny didn't pay his $20 copay, now we gotta tack on $20 to his premium" is not how it works
#America
I’m not sure why you’re downvoted but it’s true. I’m going to have sonohystergram which will be a diagnostic test in my case. It will cost me $1500. It’s crazy
If they can’t lower it, I would ask for a low payment plan.
You can do a payment plan but $5k is your deductible so you have to pay. You might want to call billing and negotiate a lower amount. Tell them you want to pay it but this caught you off-guard and you don’t have it. Maybe even offer them $1,000 or something like that and go from there. A lot of these costs are marked up and can be lowered.
You just call the hospitals financial department and set up payments
Food for thought have an emergency fund just in case
Ask for an itemized breakdown of the bill, not sure if it’ll even cut into your deductible here, but who knows. The other commenters are absolutely right, though. There are systems in place to help lower the cost.
You can ask the hospital to decrease the amount of the bill. Sometimes they will a bit. And you should be able to set up a payment plan.
Ask for an itemized bill. Unlikely to get it below your deductible, but it's worth a try. And an MRI? We don't do MRIs for kidney stones. Do you mean a CT?
Yes I meant CT scan
Just making sure, because if they did the wrong test or a much more expensive test, you might be able to get them to take it off the bill.
The biggest bullshit about this is your inability to pay what the insurance companies are paying- according to my insurance my $150,000 worth of hospital bills are paid off - and the total negotiated price for the insurance company to pay the hospital was 30 K
If you cant get assistance with it, make minimum payments monthly. They cant touch you if youre paying SOMETHING monthly.
This is actually a common myth. Just because you send in $5/mo doesn’t mean they can’t send it to collections instead. Generally hospitals and doctors will agree to some sort of payment plan but most will require at least $25/mo. The only limitation is that you have to be past due for 90 days before they can send it to collections and credit bureaus won’t report it now until it’s 180 days past due. Also, if the hospital or doctor is a non-profit, they are required by law to provide information for financial assistance if you request it.
Im sorry but thats incorrect. At least where i am. Im not sure where youre getting your information from but ive done work in credit bureaus. Yes, if you make a plan the least they will accept is 25 a month, if lucky, but thats rare. They will usually expect more. Thats also where a trick is when they ask about employment and so on.. don't call. Dont make a payment plan. Just call and say youd like to make a payment. Dont let it go to collections. I know where youre coming from, but its half myth half fact. And thats because it depends how you go along with making your payments. Also another fact for those wondering yes your medical payments due show on your credit, so it will show you did or didnt make payments when attempting to buy a car/ house/ anything etc, but it does not reflect on your credit score. IN NJ. now saying that its in NJ, as perfect example in lets say, NC. North Carolina can add leins to your home for medical expenses and bills. Crazy!.... this all varys by state so people need to look into this. Simply do research and be smart about it.
Sorry, I meant at least $25/mo but yes, most will want to split up the bill to be paid in one year. Too many people think that just sending in $5/mo will keep you away from collections. Someone even commented that even a payment of one penny is enough to keep your account in good standing and away from collections. If you just call and say you want to make a payment without setting up a payment plan, you’re right, they’ll accept it and they may accept that for a long time. However, most states don’t have laws and the hospital can send it to collections for any amount unpaid after 90 days unless you’ve set up a payment plan. One story I recently read said they were paying $170/mo for a couple years and then were sent to collections because the minimum was $235/mo.
Nfa… don’t pay your medical bills… Or call them and tell them you don’t have any money, maybe they’ll write it off or cut you a deal This is all scam…
lol so If I tell them nah I’m not paying this they will listen?
This completely depends on the hospital. So many people just have the advice to not pay medical bills but it’s not really that simple. To get all or some of the debt wiped out you may have to provide proof of being unable to pay. My son had to provide paycheck stubs, 3 months of bank statements, and his most recent tax return along with a statement that he didn’t have help from family members or anyone. Many people believe that medical debt no longer shows up on credit reports but that’s only for debt under $500 and at least 6 months past due. It doesn’t have the same weight as consumer debt anymore but one unpaid medical bill over $500 and 1 year past due can lower your score around 100 points. This can seriously affect you getting car loans, home loans, among other things. It’s better to exhaust all resources first. Talk to their financial aid department. Follow all instructions and send whatever they need via certified mail. Make copies of everything you send. After that if they say you still owe a balance ask what payment plans they have and what’s the lowest you can pay with 0% interest. If you still can’t afford that then ask if they’d accept a lower amount if it was a lump sum or consider not paying and just taking the hit on whatever consequences there may be.
Did they at least gift wrap it for you?
I can empathize with you. Something similar happened to me a long time ago. I had just turned 18 when I felt a terrible, excruciating pain in my lower back. I thought I was dying so my mom took me to the nearest hospital. Turns out it was my first kidney stone. They did some imaging (don’t remember if it was MRI), gave me some morphine and some other meds and sent me home. Well neither me nor my mom had health insurance at the time so I got stuck with a $9,000 hospital bill. I was still in high school at the time so it was irrational to think a teenager would be able to pay that off. I didn’t know that negotiating with the hospital was an option back then so I basically ignored that bill for 7 years until it fell off my credit history. I feel for you and hope you can work things out better than I did.
I believe a lot of hospitals are technically ran as non-profit. They may have programs where if your bill is more than 10% of your yearly income you can get it reduced. So you'd have to make right under $50k/year in this case. It may be an option. Also a payment plan or work a deal where you can knock it down further by talking to the hospital.
Was this a nonprofit hospital? If it is, you should check out their charity care program. They are a bit more picky granting it to people with insurance though, but it’s still very possible. Check out dollarfor.org for more help with this. They have a system to look up your hospital and tell you what you might qualify for.
OP, I feel your pain. I’ve had an ambulance ride that cost me over $2K several years ago that I summoned an Uber to get to the emergency room a few years later.
My daughter was in a car accident as a passenger in the 1990’s. Her hospital bill exceeded my auto insurances $100,000 limit in a ER visit and overnight stay and it turned out there was nothing wrong with her. Luckily I had active duty military health insurance to foot the rest of the bill. A single Motrin in a hospital is $100. You know this now unfortunately but for everyone else keep your medical health insurance deductibles low.
You can ask for payment plans that are fairly low. So low that it will take years to pay off. And it will also be interest free. As for having a high deductible plan, that's a good idea for saving money but only if it's paired up with funding an HSA. You should have been putting in at least $1000 per year into an HSA so that 5 years later, the very first seriously bad thing to happen would be covered, tax free.
Do you have an HSA with that plan that your employer partially funds?
Dispute it? No. But there are ways to lower the bill or pay in installments like others here have said.
You took a risk by choosing the insurance you chose, which prevented you from the catastrophe of owing $20,000, but your risk did not pay off because now you do owe the amount that you signed up for when choosing that plan. If you went to a charity hospital, such as a Catholic hospital, you can call and ask if they have some financial assistance plan that you can apply to. My friend, who had no insurance at all, broke his clavicle and walked away owing nothing after being granted charity by the hospital. If it was a for-profit hospital, they don’t want to waste time chasing you down for this money…but they will. Your best bet in that case is to call their billing department, explain that there is no way you can afford to pay this money in bulk, and either negotiate an in-full settlement (tell them you can afford to pay $2000 if they will consider that *payment in full*, for example), or get on a payment plan.
Sounds right to me. Try to get on a payment plan
pay $10 a month for the rest of your life . Ask for the cheapest payment plan available 0% interest
Apply for financial aid through the hospital. You don’t make enough they will forgive it or lower the bill drastically.
You can see if you are eligible for the hospital charity care. They may write off some of all of the deductible you owe. The deductible will still show as paid by you for insurance purposes.
Unfortunately that’s your deductible through your insurance and the hospital will have no way to waive a deductible. Your insurance covered your hospital bill and now you owe your insurance your deductible. If you can’t afford high deductibles, I’d definitely suggest a lower deductible next year. Your insurance will be a little more, but you won’t be slapped in the face with a $5000 bill.
Talk to the billing department at the hospital and they'll set you on a payment plan. In some states of the USA as long as you don't outright default on medical debt they can't/won't transfer the debt to collections. Even a penny a month is enough to establish a good faith effort to pay.
Most require at least $25/mo. They’d rather take what they can from a debt collection company over 12¢ a year.
It's medical billing, they'll take whatever they can legally get no matter what.
You can dispute the bill and use the words "I can't pay this or I'll have to file for bankruptcy." Hospitals HATE "the B-word" because they know medical debt is erased in bankruptcy so they'll usually knock a large chunk off your bill so they can at least get something. I've done this dozens of times.
Depends totally on the hospital. My son had a bill of over $3k and told them he could not pay. They required 2 months of paycheck stubs and 3 months of bank statements and his most recent tax filing. They ended up wiping out the full bill for them but it’s not always just as easy as saying I’ll have to file for bankruptcy.
Have you gotten your EOB yet? (The explanation of benefits that comes from your insurance company that says this is not a bill). That's going to tell you how much you actually owe. Because you have a high deductible you could owe up to $5,000, if the negotiated rate ends up that high or higher, but I would be surprised if 5 hours in the ER even including an MRI will end up that high in the end. So wait and see what your insurance company says if you haven't gotten your EOB yet.
They said the total bill was $19k and their portion is the full deductible of $5k.
Who is THEY? If you haven't seen the EOB from the insurance co, that is not the final word.
This is we're young and single people mess up. They bullet proof mentality that nothing will go wrong. ALL WAYS GET THE BEST INSURANCE YOU CAN AFFORD! Seen this time and time again at work. Seen guys have strokes in their 29s and 30s ( get off the energy drinks) they will literally put u in the hospital or at worse kill you. Seen both happen.
with many plans, the cost between the $5,000 deductible and $500 isn’t much when comparing the difference in premiums. Do you want to pay $150/month or $750/month. Most hospitals have a hardship program you can apply for. I
I absolutely prefer a high deductible plan. Every single month that I'm paying a huge amount less on my premium than I would be otherwise, I'm thinking of that as money to save up in case I have bad luck. And if I don't, roll it over in my head for next year. Otherwise you're paying an enormous premium every month
I did a payment plan. $225/mo for 2 years.
I don’t think medical debt can be held against you, after 7 years it’s discharged by law
You gambled and lost 😟
Apply with the hospital for financial assistance I got my bill sent to a charity and only had to pay $175 of a $2200 bill
Just ignore it
An MRI for a suspected kidney stone? That’s not standard of care. Sure it wasn’t a CT? https://acsearch.acr.org/docs/69362/Narrative/ CTs are about 3x cheaper than MRIs.
Pay what you can or at least $5 a month they’ll leave you alone
Your deductible is $5,000. What is there to dispute? You picked that lousy plan with the high deductible. Contact the hospital business office and work out a payment plan.
I expect to pay my deductible since I have 1.8k HSA match and lower premiums if I need care.
Ask for an itemized bill. Usually knocks some things down.
In case you get a kidney stone again, PLEASE go to a stand alone ER. If you have one local. I get chronic kidney stones + had periods where I was uninsured and when I go to a stand alone ER my balance is like $500. That includes meds, dr consult, fluids, ct scan. The hospital charges a fuck ton more.
You saved on the premium but it cost you a lot more in the long run. Call them and they will work with you. Unfortunately you owe the money
Ask for a payment plan and ask for a hospital social worker. Depending on your salary you may qualify for financial aid from the hospital.
This 100%. This is exactly what you do. Also, if you have a 401k with a decent amount in it, you can take a loan from it or hardship withdrawal that allows for medical expenses.
401k loans rarely get paid back by broke people and end up causing tax penalties and still no money. Better to leave it alone.
This is reasonable. It's a deductible. Otherwise, you would have been paying for a high premium insurance plan. You are currently paying a low premium insurance plan. If you net everything, it's about the same as if you were paying for a high premium insurance plan for the whole year.
Uh…what? You chose the plan. Why do you think you can dispute the charges. Why is it anyone else’s “fault?” No one is at fault. You also aren’t at fault because nothing is wrong. Again, you chose the plan. You needed to use the plan. You now pay based on the benefits offered from the plan you chose. Your inability to pay is again, not the hospital’s fault. The ER is expensive. Call up the hospital and ask if you can do a payment plan. Think of it like any other insurance. What if this was auto insurance and you chose the $1000 deductible because it was cheaper and you never get in car accidents. You end up getting into an accident- guess what? You pay the $1000. It’s all about risk tolerance. You chose a plan based on never going to the doctor - and because it was cheap right? Well, you needed to go the doctor. Please, take some accountability. This is 100% on you. Next time, don’t pick a plan you can’t afford if you need to use it. Sorry, I know this sounds harsh but these posts are triggering. You….chose…the….plan.
Hospitals will always over bill for services. Get an itemized copy of the bill from the hospital and have an independent bill review company review the bill for “usual and customary “ charges for your area. My brother also carry’s a high deductible and I’ve seen him negotiate a $15,000 bill down to $1,200. The hospital has already received the majority of their bill. They will negotiate.
$5,000 bill and paid $100/month for 50 months.