Health and wealth: Dealing with medical debt and discovering innovative solutions

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Medical debt is the reason cited by more than 6 in 10 people who file for bankruptcy. A growing number of consumers have been hit with lawsuits from local hospitals for overdue medical bills, and it appears that healthcare providers have grown more aggressive about collecting on these debts—in some cases threatening arrest.

Some of the unpaid debts stem from “surprise” bills that arrive when patients visit out-of-network doctors or fall into traps such as huge copayments they weren’t expecting. For example, many health insurance plans have large copayments for hospital emergency visits. In other cases, people in “preferred provider organization” (PPO) plans might visit an out-of-network (or “non-preferred”) provider, exposing themselves to “balance billing” for amounts the insurer won’t pay.

Getting slammed with unexpected medical charges is quite common. Nearly 7 in 10 people hit with unaffordable, out-of-network charges had no idea that the medical provider they consulted was not fully covered by their insurance, according to a Kaiser Family Foundation survey.

In our Summer 2020 Consumer Action News special report on the connection between health and wealth, we examine some state protections against balance billing, such as a ban on arrest for medical debt in Washington and Illinois. In some states, limited or no protections exist, which leaves only bankruptcy as a solution if providers don’t offer affordable payment plans.

Innovative solutions
The Affordable Care Act requires non-profit hospitals to notify patients of their potential eligibility for programs that help with medical bills. To help reduce the heavy burden of medical debt on consumers, advocates have called for income-based caps on monthly payments.

Consumer Action’s “Health and wealth” report offers resources on where to get free or low-cost medical attention and prescription drugs for those who don't qualify for government assistance. Federally qualified health centers can be an option for undocumented immigrants, especially crucial during today’s pandemic. For more, see “Programs that make care more financially accessible.”

Telemedicine
Since the country began coping with the coronavirus pandemic, healthcare providers have widely adopted virtual visits, which increases access to health care for some, while limiting access for others, especially older or low-income consumers who may not have reliable access to the internet.

Since the COVID-19 crisis began, many private health insurers, Medicare and, in some states, Medicaid have loosened restrictions or expanded coverage for telehealth visits. Consumer Action explains the complexities of coverage and cost in “Does my insurance cover virtual visits?

With the challenges of the pandemic, rules have been relaxed to make it easier for healthcare providers to access and share our medical information. Consumer Action reports on practical ways to protect your data, such as asking your doctor to use a telehealth platform that is HIPAA (Health Insurance Portability and Accountability Act) compliant and using video encryption for virtual visits.

For more information, see our special report, “Health and wealth: The connection.”

                                                                                                              

Through multilingual consumer education materials, community outreach and issue-focused advocacy, Consumer Action empowers underrepresented consumers nationwide to assert their rights in the marketplace and financially prosper.

 

 

 

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