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A Survival Guide to Surprise Medical Bills

How to spot errors, fight out-of-network charges and lessen the stress of health care debt

En español | What is Americans’ biggest financial concern about their health care? It isn’t insurance expenses or drug costs. It’s the specter of an unexpected bill. A February 2020 Kaiser Family Foundation poll found that 65 percent of people worry that they won’t be able to afford a surprise medical bill — more than fear being unable to pay for prescription drugs, health insurance premiums or deductibles, or for staples such as food, rent, mortgage and gas.

That probably comes as little surprise to anyone who’s opened an envelope from a hospital or doctor’s office and found a three-, four- or five-figure bill for care they thought their health plan would cover. One in three insured adults aged 18 to 64 report receiving an unexpected medical bill in the past two years, according to the Kaiser Family Foundation survey, and in 11 percent of those cases the cost exceeded $1,000.

While some states have laws in place to shield consumers from surprise medical bills, there is no nationwide protection. That may soon change. Bipartisan groups in both the House and Senate, and the White House, have gotten behind efforts to restrict the chief cause of surprise bills: "balance billing," which occurs when patients are treated at medical facilities in their health plan's network but are seen, and charged, by out-of-network doctors.

In the meantime, though, many patients still face the stress of getting a big medical bill they didn't see coming. We asked billing experts, consumer advocates, health care analysts and financial professionals for insight on surprise bills and what you can do about them. These articles aim to help you break down your bill, work with providers and insurers to reduce your costs, and pay down medical debt without jeopardizing your financial health.

Causes of Surprise Bills

Out-of-network charges and undetected errors on complex bills can drive up your costs

How to Read Your Bill

Follow these steps to spot common errors and avoid overpaying

Challenging Your Bill

Follow these steps to dispute an incorrect bill or appeal an insurance denial

Paying Off Medical Debt

When all else fails, these tools can help you deal with big health care bills

Avoiding Surprise Bills

Prevention is the best medicine when it comes to protecting your financial health

How to Read an EOB

These summaries are key to tracking medical spending and uncovering billing errors

Negotiating Medical Bills

Ask your doctor or hospital about taking less money or giving you more time to pay

Preserving Your Credit

Other types of debt are penalized more, but delinquent medical bills can still cause pain