A few years ago, I was biking with my dog through a trail. Back then, I didn’t have health insurance, I was a college student in the US working two part-time minimum wage jobs, and I wasn’t wearing a helmet. As Murphy’s law would have it, my dog pulled me hard to one side, I flew over the handles of my bike and hit my head on the concrete. Since I couldn’t get up, my mom drove me to the emergency room (ER). I spent 4 hours in the ER and was sent home with pain medication. 

A week later, I received a bill in the mail for $1,200 USD from the ER. Two days after that, I received two more bills. All together, my 4-hour visit to the ER cost me $16,000 USD. That was the equivalent of two semesters in college for me! Now what?

Unpaid medical bills create a great deal of anxiety in any person, especially when you’re not familiar with the medical system in a foreign country. The US healthcare system is very complex and if you are already receiving bills in the mail, there is no need to panic! Here are some ways to deal with medical bills:

Know your options

When I received all those bills from the ER, I had no idea what to do. My parents didn’t know the US healthcare system and didn’t speak any English. I began researching my options and learned that the hospital offered financial assistance for those that didn’t have health insurance. Many hospitals in the US have a financial assistance policy or charity care assistance. They could offer you several options:

• They might reduce your bills
• They may set you on a payment plan
• They might forgive the whole debt if you can prove that you don’t have the financial resources to pay them back 

The best advice is to call their billing office and inquire about your options. 

Did you know: Nonprofit hospitals in the US are required by law to have these assistance policies

Deal or No Deal?

The advantage of having an insurance plan is that the insurance company has already negotiated how much a doctor or a hospital can charge you for medical treatment. However, if you don’t have insurance, you will need to bring your negotiating skills to the table. Without insurance, hospitals will bill you from their chargemaster, or the full price of a medical treatment. This is where you can work out a deal and ask the hospital to lower the pricing of your bills based on how much they charge insurance companies. If you’re wondering how much a specific exam or treatment costs, you can use Healthcare Bluebook. This tool shows fair pricing for medical procedures. 

Patience and Persistence are Key

Advocating for yourself can be very stressful but like any great negotiator will tell you, you have to be persistent and patient. Medical debt is more common in the US than you think. According to a study done by Health Affairs in 2018, one in six people in the US have past-due medical bills. I started receiving calls from the hospital within a month of receiving my $16,000 medical bills threatening me with sending my bills to collections if I didn’t pay. I explained my situation to them and they put me in contact with their financial assistance office. My university also offered free legal counseling that taught me how to ask for extensions on my bills. The hospital reduced my bills to 45%. However, I was still unable to pay $7,200 USD. Eventually, they sent me to collections. Here is what I did after…

Other Resources

With the stress of exams and homework in school and working my part-time jobs, dealing with my medical bills took a backseat. The hospital sent me to collections and the calls started coming. My legal counselor at school advised me to get in contact with a medical counselor working for a non-profit credit organization. He was able to negotiate my bills down to $1,000 USD and helped me get on a payment plan with the collection agency. There are many organizations like this, however, be mindful which one has the best interest in your case. If you are offered loans, this is not the right organization. To find a credit counselor, you may visit the National Foundation for Credit Counseling. They offer assistance in English and Spanish. 

Did you know: You can ask collections agencies to stop calling you until you’ve figured out how to pay your bill.

Don’t let medical debts ruin your international education experience. You are not alone dealing with this type of debt and there are many resources to help you navigate the US healthcare system. If I’ve taken anything away from this experience that I would like to pass on to you is how to prevent medical bills in the first place:

• Wear your helmet when you’re riding a bike. Wear your mask in public. Wear your safety gear when you practice sports or your seatbelt if you’re riding in a car. Safety first!
• Having health insurance is very important. Insurance companies have contracted networks that work with several doctors and hospitals. You will not have to pay the full price since they’ve already negotiated the pricing for medical procedures.
• Be aware of what your insurance plan will and will not cover. Read through your benefits and exclusions so you don’t have unexpected expenses. You can also contact the insurance company before going to the doctor and confirm your benefits.
• When trying to find a doctor, be sure to search inside the insurance plan’s network. These are doctors that are contracted to accept your plan when using your health insurance.