Medical Bills & Debt
That bill is negotiable. Most people don't know that.
Hospital bills are sticker prices. Like buying a car, almost no one pays the number on the page. Here's how to ask for the discount you're already entitled to.
The four things you can ask for
Most non-profit hospitals — and many for-profits — have these programs. They have to. Federal law requires non-profit hospitals to offer financial assistance, but they don't always tell you about it. You have to ask.
Today
Call the billing department. Ask for the financial assistance application or charity care application. Ask for an itemized bill at the same time.
This week
Fill out the financial assistance application. Compare the itemized bill to your records — billing errors are common.
1. Charity care
Free or sharply reduced bills for low- and middle-income patients. Most non-profit hospitals offer this. Income limits vary, but at many hospitals a family at 200% of the federal poverty line qualifies for full coverage. Ask: "Do you have a financial assistance program, and how do I apply?"
2. A self-pay or hardship discount
If you're paying out of pocket — no insurance, or the bill is what your insurance didn't cover — ask for a discount. Many hospitals quietly knock 30 to 50 percent off if you ask and pay in one shot. The script: "I'm paying out of pocket. What's the cash discount?"
3. A payment plan with no interest
Most hospitals will set up an interest-free payment plan if you ask. The trick is asking before the bill goes to collections — once it's at a collection agency, the hospital usually can't help you anymore.
4. An itemized bill
Always ask for the itemized version, not the summary. Errors are common — duplicate charges, services you never received, charges for things included in another fee. Reviewing the itemized bill often knocks 10–20 percent off without any negotiation.
If the bill is already in collections
Different rules apply once a debt is sold to a collection agency, but you still have leverage. Collectors buy debts for pennies on the dollar — they have huge room to settle. You can usually settle a medical collection for 30 to 50 percent of the face value, in writing, in a single payment. Always get the settlement offer in writing before you pay, and ask them to remove the account from your credit report as part of the deal.
Where to get help
Read this next
→ How to ask for a medical bill discount
→ What to say when collections calls