Everything Changes - The Guide to Young Adult Cancer

The first step to reducing your medical debt is asking your doc or hospital to reduce your bill. This takes time, chutzpah, and smarts and is worth the work.

Asking for a discounted bill can sound impossible but it’s not.  Here’s why:  The cost of medical procedures, doctor’s time, and hospital services are not set in stone. In fact, different patients are even billed different prices for the same services. Walking into a doc’s office or hospital is not like walking into McDonald’s where a Big Mac costs the same for everyone in line.  With medical care, different people get charged different rates and your rates can be negotiated.  After all, negotiating rates is exactly what insurance companies do and you can do it for yourself too!

The National Endowment for Financial Education has a great brochure ‘Avoiding and Managing Medical Debt’.  These tips on how to ask for a reduced medical bill  are based on their expert advice:

1.  Have a positive attitude. Your odds are good: 50% of people who ask for reduced costs get them, plus using these strategies give you an extra advantage.

2.  Talk to the right person, face-to-face: Don’t do it by phone or letter. Talk in-person to your doc, your doc’s or hospital’s office, business, or billing manager.

3. Honey goes farther than vinegar. Be polite. Kill’em with kindness.

4.  Be persistent. Don’t take no for an answer.  (I never do!) Many hospital staff don’t know the correct policies and will say ‘no’ when they should say ‘yes’.  Work your way up the ladder.

5.  Build your argument. Find a copy of the hospital’s free and discounted care policy.

The American Hospital Association has a Billing and Collections Practices Policy.  4,200 hospitals have signed on agreeing to: a.) assist patients who can’t pay for all or part of their care, b.) make these policies accessible and written in clear language. Visit this link, click on ‘more than 4,200′. If your hospital is on the list, present this info in defense of your request.

6.  Contact your State Attorney General. If you’re at a non-profit hospital, many state AG’s will help ensure they provide charity care.  Find your State AG here.

7.  Compare costs. Conduct research to find out what patients with insurance or Medicare are paying for your same procedure codes. Demand the same rate.

8. Offer to pay part upfront.  Billing departments need cash from patients who often can’t paying anything at all.  Bargain for a discount in exchange for paying something upfront.  Will they cut in half a $15,000 bill if you give them $800 upfront?  Maybe.

9.  Get it in writing. When they agree to your request, get it in writing!

Does haggling for reduced costs excite or intimidate you?  Have you ever done it?

For grants, financial assistance, and money saving tips download for free the first chapter of Everything Changes: The Insider’s Guide to Cancer in Your 20s and 30s.  Scroll down on the right side of this page for the yellow highlighted download link.

Is talking about money just too taboo?  Why in the young adult cancer world do I never ever hear anyone talking about medical debt?  It’s a crying shame because we’ve got plenty of it and it seems that a bit of conversation and education is in order.  Consider these factoids:

* More than 35% of all young adults have problems with medical bills including getting calls from collections agencies, paying off medical debt, or having to seriously alter their life to accommodate for medical expenses.

* Out of every age group in the United States, 18-34 year olds have the most medical debt.

Given these statistics, it seems likely that the numbers are even higher for young cancer survivors because we are racking up mega medical bills.

I’m going to make a series of blog posts about how to avoid and resolve medical debt, information about credit card usage for cancer patients, and where to get good credit counseling.

But before I dive into these issues, I wanted to pass on a suggestion from Joanna Morales, legal guru at the Cancer Legal Resources Center.  She says: Sometimes medical debt is the result of other unresolved medical issues such as unemployment due to discrimination or other issues around disability.  How can you get out of debt if you don’t look at the root of the problem?  Brilliant idea.  Contact the Cancer Legal Resource Center (866-THE-CLRC).  They are amazing and will help you brainstorm around the factors that are contributing to your medical debt.

Do you or have you ever had medical debt?  How often do you think about it and what impact does it make on your life?  Does it change any of the decisions you make about your care?  Is this something you discuss with friends, in cancer support groups, or talk about online?  If not, why not?