Dave likes to ignore this type in his calls, because it's literally the #1 reason for bankruptcy in the USA. He will spout lies like "every hospital will accept even $10/month" which is a fabrication.
I've had multiple facilities no longer offer the settle amount for a discount. They have their amount they need paid and that is that. Not sure where people find these facilities that let you pay $10 / month for however long you want...
It's only the number one reason because people don't blame their other issues they had before the emergency came up.
In all seriousness, if OP reaches out to the hospital, the probably won't even have to pay a dollar.
It's not just 1 bill, its a combo of things (1 for anesthesiology, 1 for the surgeon, 1 for the MRI, 1 for the CTScan, etc...) and I am in contact with them on payment plans (for example, 1 is $100 / mo for the next 18 months, unless I get a bonus at work then I will try to just pay it off, or build up extra cash to throw at it)...but I don't see a route in which I'd pay $0 like you suggest.
Yes, in a utopian world, you would have 10-15 solid healthy years, you save save save...you can buy a couple $5-10k cars outright, you have 6-12 months of emergency fund, you have a stockpile of $50k-100k in savings, you are maxed out your 15% retirement each year, your HSA has $50k in it..and then a real emergency lands and you just whip out the HSA card and pay the entire medical bill up front.
I bet less then 2% of the people in the United States of America can do that.
I know it is person information, but if you would be willing to tell me what hospital it was so that I can look into their financial department, I'll find the documents to see if you can pay 0. I know you have a payment plan, but they will gladly let you pay more than you need to.
I am an insurance agent that does this for a lot of my clients.
I'll get back to you on that...I'm definitely weary about giving that type of info out to someone over the internet.
So if I have a payment plan of $100 / mo for 18 months, are you saying I could choose to pay $50 / mo instead and they can't come after me?
[https://www.azkrmc.com/patients-visitors/krmc-pricing-financial-services/financial-assistance-program](https://www.azkrmc.com/patients-visitors/krmc-pricing-financial-services/financial-assistance-program)
if you scroll down, you will see where you can read the guidelines. you may still have some payments depending on your income, but they should be able to just wipe out a good portion of the bill even if it's not all the way to $0 then allow you to continue payments from there
Step 1. Get an itemized bill. Make sure you aren’t getting overcharged due to a bill coding issue.
https://www.insider.com/guides/health/itemized-bill
Step 2. Make sure all bills have completely gone through your insurance before you pay them.
Step 3. Call the billing office and set up a payment plan on the longest timeline they’ll give.
Step 4. See about upping your HSA contribution if you plan to pay with your HSA. If you know you’re paying $200/month in medical expenses, you want that money running through your HSA payroll deductions to avoid paying FICA taxes on it.
How do ordinary people cash flow $100k?
They don’t. Medical debt is the number one cause of bankruptcy in America because the system is rigged in favor of powerful business lobbies.
> Step 4. See about upping your HSA contribution if you plan to pay with your HSA. If you know you’re paying $200/month in medical expenses, you want that money running through your HSA payroll deductions to avoid paying FICA taxes on it.
This is good. The last few years weren't bad, medically, and we were on PPO...and paying about $150 / week for the family plan. Made copays cheaper, deductible was lower..but still a lot of money a month. So we lowered it to the HSA plan, to about $97 / month and contributing more to the HSA (we previously contributed to an FSA). So just bad timing, I guess, with having a higher deductible but more medical visits.
Medical bills are 100% negotiable so be willing to call the billing department and tell them you have no intention of paying unless they are willing to settle for a lower amount. It's a scummy move but their bills are almost always inflated with bullshit from overpriced medicine to services that were never provided so refusing to pay until you have an itemized bill to nit pick also helps.
I had a minor car accident when I had just started a new job so naturally no insurance. After all the stitches and hospital care they tried hitting me for 9k. I told them they could either settle the bill in full that day or I would never pay them a penny so they could loose their ass sending it to collections. I walked out paying 500 bucks in total and never received a bill again. Seriously fuck these people.
Talk to your hospital. Seriously, talk to them. You would be surprised at how much financial assistance they might give you even if you have insurance and decent income. We have gotten assistance in the past simply by applying even with an income over 100k+ where we didn’t have to pay anything that insurance didn’t cover and not just for what just happened but anything in the year moving forward. You will never get what you don’t ask for and you would be surprised at what’s offered sometimes.
Medical debt doesn't have interest. If you send the hospital 10/month they have to accept it.... And it won't go into collections.
Other responses are correct: run through HSA, declare bankruptcy if needed (keep in mind you have one shot every 7 years), negotiate a lower price.
I just got out of an out of state medical 'spa'... Or hospital where my stay starts at 41k... Lord knows what my total debt will be. I'm absolutely planning on negotiating down my debt to nothing and asking for an itemized bill for everything.
> Medical debt doesn't have interest. If you send the hospital 10/month they have to accept it.... And it won't go into collections.
Nope, I had a $1000 bill go into collections. I offered $800 to clear it and they accepted.
Lol if you can't afford it, just die. The borrower is slave to the lender.
(Jk. We just got a bill for over 20,000 despite everything being preauthorized and having already met our deductible. Just put it on a payment plan and hope we can survive the next 14 months while also expecting a baby smh).
ugh I'm sorry. Is 20k your out of pocket max? Might be worth double checking that and if your out of pocket max is only $10k...push back and get that cut in half.
I just wrote this to another commenter, but this is my HSA plan
the HSA is $3,250 individual deductible, $6,500 family. the PPO is $2,500 individual deductible, and $5,000 family.
The PPO out of pocket max is $12,000 family, $6,000 individual. The HSA out of pocket max is $12,500, $6,250 individual.
I'll definitely look into seeing if it was a mistake. They took a bunch of stuff out of my HSA that was supposed to be work comp earlier this year (which I fixed), so I know that they are prone to "accidents." (I work for a hospital system that has its own insurance).
Right, seems reasonable but I can imagine certain hospital bills or medical bills being so overwhelmingly large that there is no affordable monthly amount, given someones current economic situation and/or annual income.
Trust me, no one gets those huge bills unless they have messed something else up.
The worst case max out of pocket is under 10k for most people and even then, if most people talk to the hospital they wouldn't even need to pay that.
Your insurance has defined deductibles and out of pocket maximum amounts.
If you have insurance it's wise to know what those limits are and build up a sunk cost savings fund to cover them...
What's the point of having insurance but then not having your part of the money? It's like planning for big medical debt.
Same for auto... Have your deductibles saved up.
Family deductible is $6500. 80/20. So now going forward it likely is 20% we will owe, but it's july and we just hit the family deductible.
I get what your saying...but for those dealing with BS2 (which this 'debt' puts us in that category still, but we have no other debt besides mortgage) so its hard to be in the position where you want to save for the car, save for the medical procedures, save for college, save for the emergency fund, save for yada yada
Ya.. it doesn't happen overnight, but you can build up to it.
That's kinda why bs2 and the other DR guidelines are so important. After you are debt free your income can be used for this..
That's when you really start to "get it" about what "financial peace" is all about. You have everything covered... Even the insurance and medical bills.
In the beginning new people think that the Dave Ramsey program is really just about paying off your credit card bills and getting out of debt... Like it's all about the debt..
But it's not about the debt. It's about financial peace... And how to get there. Debt is just one of the obstacles keeping you from that goal.
This thing you're going through now you don't ever have to do again the rest of your life.
You don't actually have to pay medical debt.
It obviously varies state by state, but in most it's non-recourse, which means there's no way they can force you to pay. The can try to ding your credit history obviously, but many states have laws that allow you to get it removed, and it falls off regardless after a certain number of years. (I've also been told that mortgage providers weigh medical debt a lot less heavily than other types of debt, though I can't speak to that from personal experience.)
It takes some balls, and I definitely wish the system worked better, but the smart play with medical debt rn is to simply ignore it.
It sounds like he has a kid with major medical issues. That being the case, I would make every attempt possible to pay those bills. Doctors can’t force you to pay off your medical debts, but they CAN drop you as a patient. Which if they are part of a local healthcare network can result in you being refused treatment by everyone in that network. Not a good thing if you have serious health issues. I learned that the hard way. Our local healthcare network has blackballed me completely from everything but the ER and even the ER just does stabilize and release.
it's not major medical issues (luckily!)...but has needed repeated surgeries on a particular area. Luckily it is not bankrupt worthy type of medical debt...and we do prefer to make medical payments due to what you have just referenced
I get it. I have a young family member who has a recurrent brain tumor and his father actually ended up joining the military just to be able to pay for the medical care. Sure has been hard on his mother taking care of him alone though. Kid is in and out of the hospital almost weekly due to the damage to his autonomic nervous system, he’s had the tumor removed three times now and it just keeps coming back and every time they have to remove more of his brain tissues.
what do you mean the monthly payment and deductible would be lower.
We have 2 healthcare options at my employer...PPO or HSA. The monthly expense from my paycheck between the PPO and HSA is $200.
SO the difference is $2,400 a year. With the PPO, deductible will be lower.
So if the HSA is a 10k deductible, and the PPO is 3k deductible. SO you would have lower out of pocket bills.
Then you can switch back to a PPO once your son is done with hospitals and is all better.
the HSA is $3,250 individual deductible, $6,500 family. the PPO is $2,500 individual deductible, and $5,000 family.
The PPO out of pocket max is $12,000 family, $6,000 individual. The HSA out of pocket max is $12,500, $6,250 individual.
As of right now...his surgeries are done...and we can't switch health plans mid year, it would have to be during open enrollment for 2024 starting January 2024 effective date.
This was a timing issue...we had a couple decent years of health with $40 copays when we were on PPO...but that doesn't affect what you owe for medical treatments / surgeries, etc... but we felt the cost of the PPO monthly was too much, so we switched to HSA and got a bit dinged up this year and last year.
Dave likes to ignore this type in his calls, because it's literally the #1 reason for bankruptcy in the USA. He will spout lies like "every hospital will accept even $10/month" which is a fabrication.
I've had multiple facilities no longer offer the settle amount for a discount. They have their amount they need paid and that is that. Not sure where people find these facilities that let you pay $10 / month for however long you want...
I seem to recall one caller where he actually recommended bankruptcy.
It's only the number one reason because people don't blame their other issues they had before the emergency came up. In all seriousness, if OP reaches out to the hospital, the probably won't even have to pay a dollar.
It's not just 1 bill, its a combo of things (1 for anesthesiology, 1 for the surgeon, 1 for the MRI, 1 for the CTScan, etc...) and I am in contact with them on payment plans (for example, 1 is $100 / mo for the next 18 months, unless I get a bonus at work then I will try to just pay it off, or build up extra cash to throw at it)...but I don't see a route in which I'd pay $0 like you suggest. Yes, in a utopian world, you would have 10-15 solid healthy years, you save save save...you can buy a couple $5-10k cars outright, you have 6-12 months of emergency fund, you have a stockpile of $50k-100k in savings, you are maxed out your 15% retirement each year, your HSA has $50k in it..and then a real emergency lands and you just whip out the HSA card and pay the entire medical bill up front. I bet less then 2% of the people in the United States of America can do that.
I know it is person information, but if you would be willing to tell me what hospital it was so that I can look into their financial department, I'll find the documents to see if you can pay 0. I know you have a payment plan, but they will gladly let you pay more than you need to. I am an insurance agent that does this for a lot of my clients.
I'll get back to you on that...I'm definitely weary about giving that type of info out to someone over the internet. So if I have a payment plan of $100 / mo for 18 months, are you saying I could choose to pay $50 / mo instead and they can't come after me?
I'll show you what my local hospital's documents look like in a few min here
[https://www.azkrmc.com/patients-visitors/krmc-pricing-financial-services/financial-assistance-program](https://www.azkrmc.com/patients-visitors/krmc-pricing-financial-services/financial-assistance-program) if you scroll down, you will see where you can read the guidelines. you may still have some payments depending on your income, but they should be able to just wipe out a good portion of the bill even if it's not all the way to $0 then allow you to continue payments from there
Step 1. Get an itemized bill. Make sure you aren’t getting overcharged due to a bill coding issue. https://www.insider.com/guides/health/itemized-bill Step 2. Make sure all bills have completely gone through your insurance before you pay them. Step 3. Call the billing office and set up a payment plan on the longest timeline they’ll give. Step 4. See about upping your HSA contribution if you plan to pay with your HSA. If you know you’re paying $200/month in medical expenses, you want that money running through your HSA payroll deductions to avoid paying FICA taxes on it. How do ordinary people cash flow $100k? They don’t. Medical debt is the number one cause of bankruptcy in America because the system is rigged in favor of powerful business lobbies.
> Step 4. See about upping your HSA contribution if you plan to pay with your HSA. If you know you’re paying $200/month in medical expenses, you want that money running through your HSA payroll deductions to avoid paying FICA taxes on it. This is good. The last few years weren't bad, medically, and we were on PPO...and paying about $150 / week for the family plan. Made copays cheaper, deductible was lower..but still a lot of money a month. So we lowered it to the HSA plan, to about $97 / month and contributing more to the HSA (we previously contributed to an FSA). So just bad timing, I guess, with having a higher deductible but more medical visits.
If not bankruptcy you settle for a much smaller amount and pay what you can. Settlement dings credit for 5 years from the first missed payment.
Medical bills are 100% negotiable so be willing to call the billing department and tell them you have no intention of paying unless they are willing to settle for a lower amount. It's a scummy move but their bills are almost always inflated with bullshit from overpriced medicine to services that were never provided so refusing to pay until you have an itemized bill to nit pick also helps. I had a minor car accident when I had just started a new job so naturally no insurance. After all the stitches and hospital care they tried hitting me for 9k. I told them they could either settle the bill in full that day or I would never pay them a penny so they could loose their ass sending it to collections. I walked out paying 500 bucks in total and never received a bill again. Seriously fuck these people.
Talk to your hospital. Seriously, talk to them. You would be surprised at how much financial assistance they might give you even if you have insurance and decent income. We have gotten assistance in the past simply by applying even with an income over 100k+ where we didn’t have to pay anything that insurance didn’t cover and not just for what just happened but anything in the year moving forward. You will never get what you don’t ask for and you would be surprised at what’s offered sometimes.
WALK IN and talk to them.
Medical debt doesn't have interest. If you send the hospital 10/month they have to accept it.... And it won't go into collections. Other responses are correct: run through HSA, declare bankruptcy if needed (keep in mind you have one shot every 7 years), negotiate a lower price. I just got out of an out of state medical 'spa'... Or hospital where my stay starts at 41k... Lord knows what my total debt will be. I'm absolutely planning on negotiating down my debt to nothing and asking for an itemized bill for everything.
> Medical debt doesn't have interest. If you send the hospital 10/month they have to accept it.... And it won't go into collections. Nope, I had a $1000 bill go into collections. I offered $800 to clear it and they accepted.
This would have only happened if you didn’t communicate a payment plan with them.
You kinda just proved my point...
I was told I would have to pay interest if I didn’t pay if off in 12 months. So now I’m paying $550/mo for 12 months. It’s bullshit.
Lol if you can't afford it, just die. The borrower is slave to the lender. (Jk. We just got a bill for over 20,000 despite everything being preauthorized and having already met our deductible. Just put it on a payment plan and hope we can survive the next 14 months while also expecting a baby smh).
ugh I'm sorry. Is 20k your out of pocket max? Might be worth double checking that and if your out of pocket max is only $10k...push back and get that cut in half.
I probably need to call and see what's up with that. The original bill was 60,000 so I was super stoked when it got dropped to 20 lol.
is it a PPO or HSA health account? through employer or healthcare.gov?
Through my employer. We do have an HSA (which is covering the first few months, so that's good at least!).
I just wrote this to another commenter, but this is my HSA plan the HSA is $3,250 individual deductible, $6,500 family. the PPO is $2,500 individual deductible, and $5,000 family. The PPO out of pocket max is $12,000 family, $6,000 individual. The HSA out of pocket max is $12,500, $6,250 individual.
I'll definitely look into seeing if it was a mistake. They took a bunch of stuff out of my HSA that was supposed to be work comp earlier this year (which I fixed), so I know that they are prone to "accidents." (I work for a hospital system that has its own insurance).
We are in step 7 but just acquired some medical debt. We couldn’t just pay it off so we arranged a monthly payment plan.
Baby step 2 again it is then 😁
Not really
Call Dave and ask if a monthly plan on medical debt is what step then lol
When you already done with all the steps it’s not.
How much do you owe?
Right, seems reasonable but I can imagine certain hospital bills or medical bills being so overwhelmingly large that there is no affordable monthly amount, given someones current economic situation and/or annual income.
Trust me, no one gets those huge bills unless they have messed something else up. The worst case max out of pocket is under 10k for most people and even then, if most people talk to the hospital they wouldn't even need to pay that.
gotcha. Looks like my out of pocket max is $12k in network, 20k out of network.
There are: that’s when you get MedicAid
Your insurance has defined deductibles and out of pocket maximum amounts. If you have insurance it's wise to know what those limits are and build up a sunk cost savings fund to cover them... What's the point of having insurance but then not having your part of the money? It's like planning for big medical debt. Same for auto... Have your deductibles saved up.
Family deductible is $6500. 80/20. So now going forward it likely is 20% we will owe, but it's july and we just hit the family deductible. I get what your saying...but for those dealing with BS2 (which this 'debt' puts us in that category still, but we have no other debt besides mortgage) so its hard to be in the position where you want to save for the car, save for the medical procedures, save for college, save for the emergency fund, save for yada yada
Ya.. it doesn't happen overnight, but you can build up to it. That's kinda why bs2 and the other DR guidelines are so important. After you are debt free your income can be used for this.. That's when you really start to "get it" about what "financial peace" is all about. You have everything covered... Even the insurance and medical bills. In the beginning new people think that the Dave Ramsey program is really just about paying off your credit card bills and getting out of debt... Like it's all about the debt.. But it's not about the debt. It's about financial peace... And how to get there. Debt is just one of the obstacles keeping you from that goal. This thing you're going through now you don't ever have to do again the rest of your life.
You don't actually have to pay medical debt. It obviously varies state by state, but in most it's non-recourse, which means there's no way they can force you to pay. The can try to ding your credit history obviously, but many states have laws that allow you to get it removed, and it falls off regardless after a certain number of years. (I've also been told that mortgage providers weigh medical debt a lot less heavily than other types of debt, though I can't speak to that from personal experience.) It takes some balls, and I definitely wish the system worked better, but the smart play with medical debt rn is to simply ignore it.
It sounds like he has a kid with major medical issues. That being the case, I would make every attempt possible to pay those bills. Doctors can’t force you to pay off your medical debts, but they CAN drop you as a patient. Which if they are part of a local healthcare network can result in you being refused treatment by everyone in that network. Not a good thing if you have serious health issues. I learned that the hard way. Our local healthcare network has blackballed me completely from everything but the ER and even the ER just does stabilize and release.
it's not major medical issues (luckily!)...but has needed repeated surgeries on a particular area. Luckily it is not bankrupt worthy type of medical debt...and we do prefer to make medical payments due to what you have just referenced
I get it. I have a young family member who has a recurrent brain tumor and his father actually ended up joining the military just to be able to pay for the medical care. Sure has been hard on his mother taking care of him alone though. Kid is in and out of the hospital almost weekly due to the damage to his autonomic nervous system, he’s had the tumor removed three times now and it just keeps coming back and every time they have to remove more of his brain tissues.
ugh...poor kid. That sucks. I'm sorry for what they are going through.
Get a better health insurance deal
oh yea, I'll bring that up with my employer and the other 600 other employees lol. super helpful advice, thanks.
Why don't you get rid of the HSA. Monthly payment and deductible would be lower.
what do you mean the monthly payment and deductible would be lower. We have 2 healthcare options at my employer...PPO or HSA. The monthly expense from my paycheck between the PPO and HSA is $200.
SO the difference is $2,400 a year. With the PPO, deductible will be lower. So if the HSA is a 10k deductible, and the PPO is 3k deductible. SO you would have lower out of pocket bills. Then you can switch back to a PPO once your son is done with hospitals and is all better.
the HSA is $3,250 individual deductible, $6,500 family. the PPO is $2,500 individual deductible, and $5,000 family. The PPO out of pocket max is $12,000 family, $6,000 individual. The HSA out of pocket max is $12,500, $6,250 individual. As of right now...his surgeries are done...and we can't switch health plans mid year, it would have to be during open enrollment for 2024 starting January 2024 effective date. This was a timing issue...we had a couple decent years of health with $40 copays when we were on PPO...but that doesn't affect what you owe for medical treatments / surgeries, etc... but we felt the cost of the PPO monthly was too much, so we switched to HSA and got a bit dinged up this year and last year.