Authors

Patricia Kelmar, JD
Senior Director, Health Care Campaigns, U.S. PIRG Education Fund

Quynh Chi Nguyen
Associate Director, Center for Community Engagement in Health Innovation at Community Catalyst

Introduction

Your one-stop guide to understand and fight your medical bills

As the cost of health care has grown ever higher, you may find your personal budget strained.

Health care prices are at an all-time high and continue to grow. That means — even if you have health insurance — more medical bills become your financial responsibility. You may find yourself paying for a monthly health insurance premium in addition to an annual deductible, copays, and coinsurance for each visit to the doctor’s office or hospital. If you are one of the millions of people in the United States who do not have health insurance, you are forced to pay the full amount of every single doctor’s visit, blood draw, or E.R. trip — which is no small thing, considering the average price of a routine doctor’s visit is between $300 to $600 alone.

An animation of a hospital in the background of a neighborhood with houses lined on both sides of the street

These costs can be devastating to your financial security. In fact, nearly four in ten people in the U.S. have medical debt. This includes nearly 11 million people who owe more than $2,000 and 3 million people who owe more than $10,000. Black adults (16 percent) report a disproportionate amount of medical debt compared to white adults (9 percent).

Medical debt can lead to home foreclosures, personal bankruptcies, and reduced credit scores. It also has health-related consequences, like causing people to delay a medically necessary treatment due to the cost. 

That’s why it’s so important to learn how to handle your medical bills and use your rights to avoid unnecessary billing charges. In some cases, you may even need to fight an illegal medical bill. 

This guide is meant to help you navigate medical bills and other common charges in health care settings — like when you need emergency care, are scheduling care at a hospital, or are faced with unaffordable medical bills. Simply select the subject that applies to you to learn more.

Know Your Rights in Medical Billing

I Have Health Insurance and Need Emergency Care

In emergency situations, you often don’t choose the ambulance or the hospital. You have legal protections against emergency room, out-of-network surprise medical bills — which are described below.

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I Have Health Insurance and Need to Schedule Hospital Care

Health care can be expensive. When you have health insurance and need to schedule hospital care, there are some things you can do to lower the amount that you will have to pay out-of-pocket.

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I Am Uninsured and Need Medical Care

If you are uninsured or “self-pay” (or not planning to submit your medical bills to a health insurance company), it can be helpful to know what you will be charged for your medical care.

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I Received a Medical Bill I Cannot Afford to Pay

Whether you are insured or uninsured, medical bills can be expensive and surprising. This guide explains how to ensure the bill is correct and what to do if you cannot afford to pay it.

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I Am Unable to Pay for My Care Up Front

Negotiate with your health care provider to lower the amount you have to pay for your bill upfront or overall. Patient advocate departments at hospitals or community organizations can help you apply for financial assistance programs, set up a no-interest repayment plan, or reduce your bill.

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My Unpaid Medical Bill Was Sent to Collection Agency

If you don’t pay your medical bill, the provider can sue you for payment or sell your debt to a collection company. If you fail to pay your bills, it can also hurt your credit score. However, some states have laws that prohibit health care providers from using certain collection practices against patients to collect unpaid medical bills. 

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Know Your Rights

If English is not your primary language, you have the right to request and receive language assistance when receiving health care. You may ask for an interpreter and/or translation of all documents related to your medical services, including medical bills, financial assistance application, and consent forms.

If you believe your rights have been violated, or if you are unsure — contact a legal aid organization in your area.

In Partnership With

U.S. PIRG Education Fund logo

About the Authors

Patricia Kelmar, JD
Patricia is an attorney and advocate directing high value health care campaigns work for U.S. PIRG Education Fund and U.S. PIRG. PIRG is a federation of independent, state-based, citizen-funded Public Interest Research Groups in 25 states, whose role is to find common ground around solutions that will make our future healthier, safer and more secure.

Quỳnh Chi Nguyễn
Quỳnh Chi is an Associate Director for the Center for Community Engagement in Health Innovation at Community Catalyst. In this role, Quỳnh Chi oversees two major projects on community benefits and economic stability, and hospital equity and accountability. She also supports local and state health advocacy organizations that are working to improve economic stability. She has expertise in several policy areas, including affordability, health insurance coverage, prescription drug costs, and health justice.

Acknowledgements

We are grateful to the following individuals for their input and support:

Julia Char Gilbert
Connelly Policy Advocate
Colorado Center on Law and Policy

Nicolas Cordova
Attorney, Healthcare Director
New Mexico Center on Law and Poverty

Berneta L. Haynes
Senior Attorney
National Consumer Law Center

Sherrell Byrd
Founder and Executive Director
SOWEGA Rising

Download the English Guide
Download the Spanish Guide

Community Stories

Waiting for the Bill: Kaylynn’s Story Kaylynn, who has long, wavy light brown hair. leans against a wall with gray siding. She is one of tens of millions of Americans faced with medical debt. Kaylynn

Waiting for the Bill: Kaylynn’s Story

Planting Seeds for Change: SOWEGA Rising Sherrell Byrd, Founder & Executive Director of SOWEGA Rising, which builds community power in southwest Georgia. Sherrell started the non-profit after her experience with medical debt.. Sherrell

Planting Seeds for Change: SOWEGA Rising

Between Life and Debt: Aracely’s Story Aracely is standing in their home next to a chair, wearing a dark teal button-down blouse with rolled up sleeves to reveal a delicate tattoo that covers most of their right forearm. Kitchen cabinets and a countertop, and a collection of art in black frames on a wall, are in the background. Aracely, who wears large, light gray glasses, has dark, shoulder-length hair and wears a black-knotted headscarf that covers part of their head. Aracely has a slight smile with a closed mouth. Aracely

Between Life and Debt: Aracely’s Story

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