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Tips and advice on medical debt for the 100 million Americans struggling to pay

Dr. Elizabeth Maziarka reads a blood pressure gauge during an examination of a patient. (Joe Raedle/Getty Images)
Dr. Elizabeth Maziarka reads a blood pressure gauge during an examination of a patient. (Joe Raedle/Getty Images)

More than 100 million Americans are saddled with medical debt arising from health care costs.

According to a joint investigationby Kaiser Health News and NPR, just over half of all American adults have grappled with some form of medical debt in the past five years. The report also found that most Americans do not know how to avoid health care-related debt.

Jeanne Pinder, CEO and founder of ClearHealthCosts.com, says the high price of medication, routine procedures and consultations play a major part. The cost of essential medical practices, she says, are far more expensive in the U.S. than in almost any other developed nation.

“The system is run by people and organizations that are focused on their 7% growth for next year and not your $2,000 deductible bill,” Pinder says.

Repercussions for those who accrue medical debt manifest in a wide range of ways. Some see their credit scores plummet or lose their home or car when they cannot pay the astronomical rates. Others avoid seeking medical care altogether in fear of accumulating a mountain of debt.

“We hear of people who are being taken to court,” Pinder says. “We hear of people who actually have had so many medical bills that they refuse to go to the hospital or the doctor because they are afraid they can’t pay.”

Pinder offers advice on how patients can work the system in their favor for routine checkups and procedures. Her methods are tried and true: Pinder recently obtained a routine MRI for a family member. She asked to pay as a cash customer, which massively reduced the cost of the scan.

Pinder advises patients to check out the below resources if they get into a tricky situation with medical bills. The health care system can appear confusing and complex, so Pinder shares some pointers on how to navigate it. And, you can read her blog post about appealing a bill.

Tips for navigating medical costs and debt, from ClearHealthCosts.com CEO Jeanne Pinder

  1. Follow the insurer’s or the hospital’s protocols as closely as possible. Yes, this can be highly frustrating and time-consuming, but it ensures you have the best chance of a good outcome and is the best way to avoid ending up in collections or, worse, court.
  2. Know your rights. State laws differ greatly — some states have laws that protect your primary home, car and even your livestock from collection activities. Some state laws protect your bank account, paycheck or child support. This National Consumer Law Center reportshows state-by-state protections for what can and cannot be confiscated by a debt collector.
  3. Scare tactics are not uncommon. Don’t give in. Collection activities are governed by the federal Fair Debt Collection Practices Act, which details what debt collectors can do and how. For example, they cannot call you in the middle of the night or threaten to involve your employer.
  4. It’s up to you to guard your credit. The federal Fair Credit Reporting Act covers how debt collection should be reported in credit reports. If a creditor is adding multiple negative reports to your record, they may be breaking or bending the law. A bad credit report may mean that you’ll pay more for your mortgage, credit card and car loan.
  5. Did you get sued for an overdue debt? Don’t ignore the legal paperwork. If you ignore it, chances are it will only get worse. Put your challenge in writing. Show up in court if need be.
  6. A new federal law is designed to protect people against surprise medical bills. The U.S. Public Interest Research Group wrote this breakdown of protections for patients against surprise billings.
  7. Need more details? The ​​National Consumer Law Center collects Consumer Debt Advice and compiles articles about medical debt. The Consumer Finance Protection Bureau offers these consumer tools on debt protection.
  8. A number of organizations can help people with medical and other bills in collection. They may be state or local organizations. In New York City, the Community Service Society of New York will help you argue a bill. In Texas, and other states, the Legal Aid folks may be your best bet: Texas Rio Grande Legal Aid orLone Star Legal Aid. Legal Aid Society of Cleveland is another or Legal Services of Alabama. See a list of resources collected by the Consumer Finance Protection Bureau here.
  9. The Consumer Finance Protection Bureau accepts complaints and queries about the companies that are named. You can contact the bureau online or by phone at (855) 411-2372. The process is described on this page.

Thomas Danielian produced and edited this interview for broadcast with Gabe Bullard and Catherine Welch. Danielian also adapted it for the web.

This article was originally published on WBUR.org.

Copyright 2022 NPR. To see more, visit https://www.npr.org.