Pay Your Bills on Time

Lots of people have the money to pay their bills, but they are lazy and sloppy. They figure no one is calling demanding the cash, so what's the hurry? I hope that's not you. If it's a loan from a friend, you're likely to lose that friend. If it's a loan from a relative, you're storing up long-term resentment that can bite you in the future. If it's a credit card bill or utility bill, you're looking for trouble when attempting to get more credit to buy a house or a car, or obtain any kind of loan on low-interest terms.

My latest credit card bill devoted two pages to what it called "Useful Tips." Here they are:

1. Pay on time.
2. Pay at least the monthly minimum.
3. When you can, pay in full.

Pay on time? What's that? If your attitude about paying promptly is lax, do not be surprised when your credit scores go down and the cost of credit to you goes up. Entities that loan money take regular on-time payments as a mark of your financial responsibility. The credit card companies do not need to know how much money you have in a bank account or the stock market. The companies want to know if you will pay on time. If you do pay on time, you will always get better treatment from your creditors than if you don't.

If you are too disorganized to pay your bills on time, simplify them. Many bills can be put on autopay, or you can set an alarm on your phone or computer to remind you to pay them all the day you receive your paycheck. You also can charge only to one credit card each month (rotate through them to keep them active). You don't need to use store charge accounts when they accept major credit cards, another way of reducing the number of bills you receive. If you want to take advantage of a store card benefit such as a discount, use the card, but then walk over to the store's service desk and write a check then and there to pay the amount you just charged. Done.

Pay at least the monthly minimum. This is another no-brainer, since your creditors will tell you exactly what the minimum is. If you really want to pay their exorbitant finance charges, go right ahead, but at least avoid late payment and low payment fees. The minimums due are very low and the late payment fees are very high.

When you can, pay in full. We now have consumer laws in place to require our creditors to remind us that stretching payments over many months or years results in paying two or three or more times the purchase price. It's not a bargain buy if you end up paying three times the price. Think twice about buying anything you can't pay for in full by the end of the first billing cycle.

There is no "secret they don't want you to know" when it comes to paying your bills. There is nothing fancy or mysterious about maintaining good credit. Pay on time.

What a Dog Bite Costs You

Someone I know got bitten by a dog. He was taking his nightly walk in his neighborhood, and a lady walking her dog did not control the animal. It leaped at him and bit him. He cried out, "Your dog bit me," but the lady said, "No, he didn't, " and she ran away.

It was dark. He didn't know her or the dog. He certainly couldn't chase her. A man chasing a woman on a dark street? The police could have deemed that assault. He never got a good look at her or the dog. So he went home.

After he got home, he collapsed in a faint, and a relative rushed him to the ER. The ER doctors did a nice job, explained that the faint wasn't life-threatening, and shot him full of meds. They told him to come back for the necessary series of rabies shots. You'll be relieved to know these shots were not in his stomach, as legend has it, but in his arm.

Rabies is still a fatal disease, so opting not to get rabies shots is a mortal risk. Especially since where my friend lives nearly an estimated one-third of all dogs have not had their shots. Most jurisdictions offer rabies inoculations free when you apply for a dog license. Free as in free. A pretty good deal to safeguard your dog and your fellow citizens. But many people do not license their dogs.

The bills for treating the dog bite have now arrived. My friend has health insurance with a yearly $2,500 deductible since he's young and healthy. After the deductible was met and insurance paid its share, the out-of-pocket cost of this dog bite was $4,000 for the ER visits and the shots. Bills from the ER doctor and from the hospital are still expected.

That's right. Four grand.

Would there have been any way to get the shots less expensively? Probably not the first set, since they were given in an emergency situation. Perhaps my friend's regular doctor could have ordered the vaccine for the follow-up shots, and they would have cost less. Perhaps not. My own attempts to get my doctor to order the shingles vaccine were fruitless, despite it supposedly being commonly available. With rabies, my friend could not take a chance and wait to see if maybe his doctor could get the vaccine. His other option might have been to go to a freestanding pharmacy that gives shots, but again, whether the pharmacy could obtain the vaccine in a timely manner is a question. Most insurance plans will not reimburse for shots gotten at a pharmacy, at least, not without a fight.

The only sure way around the enormous cost of rabies shots would be to identify the dog and determine if it had been inoculated. I suppose my friend could have gone door to door in the neighborhood and attempted to describe the lady and her dog, but since he didn't really know what they looked like, he thought it was pointless. He could have reported the incident to the police as an act of good citizenship, but that might have been pointless, too. He knows that if identified, the lady could claim that he attacked her and her dog was protecting her. That's a serious charge and he might get arrested and have to hire a lawyer to be cleared. Meanwhile, her dog would be automatically impounded, and if not inoculated, would be destroyed. As soothing as that idea might be, the price my friend would pay would be too high: possible arrest, a police record, and a lady who is really, really mad at him. You're thinking, "Why should a man fear the vengeance of a woman?" Why not? Her dog bit him without provocation. Is she likely to be any nicer than her dog? Dogs don't just bite people; they get schooled to behave badly by their owners.

I advised my friend to carry a stick from now on when he takes his nightly walk. But there is some risk to him to be seen carrying a stick since he is not elderly. As it is, most women steer clear of a man on the sidewalk, just in case. This situation is a tough one, and expensive, too.




  

  
 

I Disagree with Suze Orman About This One

Last night the Suze Orman show was a repeat. That was surprising enough, but it was a repeat that when it first aired I thought gave poor advice. The setup was this: an employed woman in the social work therapy field has been spending unwisely, and now wants help. She has zero money, plus college debt, car loan debt, and credit card debt. Nothing unusual there.

The shocker was that this person admitted she had forged her mother's name to a college loan application. Suze Orman has several times had people on her show whose irresponsible parents had forged their names to get new credit cards, and effectively destroyed their child's credit before the child even reached majority. In no case did anyone suggest prosecuting any of these forgers for what, in my mind at least, appears to be a criminal act. And so it was last night on Suze's show. She chided the guest for being so self-centered and determined to get her own way, and that was that.

Suze did come down pretty hard on the guest for opening an account at an eyeglass store, buying expensive designer sunglasses, and then never paying a dime on the account. Suze likened it to shoplifting, which I thought was an apt analogy. If something is bought with a general credit card that is being used and paid regularly, the merchant does eventually get some payment. But if it's bought with a store card and no payments are made to the store account, the store is out the full amount.

Here's where I disagree with Suze: She suggested a very tough cutback of monthly expenses. I took one look at the guest and knew that would never happen. You don't tell a dog owner who has a good-paying job that she can't afford to own a dog. You tell that to a dog owner who does not have a job and is about to be evicted or foreclosed on. Then the person might listen. Suze also wanted to cut a fairly small amount per month of entertainment expenses to the bone. It doesn't make sense; people need to have an entertainment budget. I get that this person's bad behavior might cry out for punishment; Suze did confront her about making excuses to justify every rash financial action. But demanding an unrealistic period of financial sackcloth and ashes won't work. 

Suze was correct to tell the guest that she needed to earn more money and use that money to pay off her student loans and then her debts. But Suze was so busy talking about cuts to ordinary monthly expenses that she didn't give the details or emphasize that making more money was the only way the guest could balance her budget. If you don't have enough money to pay your bills, you need to get more money. Spending less is only a temporary fix unless you have been spending like a wild man. Saving $40 a month by having no entertainment budget--hardly a wild man amount--is meaningless when you can earn $1,000 more a month by just working longer hours. Suze was too concerned with punishment and not enough interested in building up the guest's feeling of having the power to solve her financial woes. And yet the guest is to receive no punishment for forgery or for messing up her mother's credit situation. Nor is she to make restitution to the eyeglass store she never paid for her designer sunglasses. Not good enough, Suze.

We all do have some power to control our financial problems, some of us more than others. In last night's case, here was a single woman with a very good job, who could easily earn more money, get out of debt, and start a savings program. She could pay back the eyeglass company in just one month. She could also make amends to her mother by paying her a set amount of money every month for several years, to reduce the effects of having ruined her mother's credit score (and thus causing her mother to suffer higher rates on her credit). I think Suze missed the boat on this one. 

We all know people who have behaved badly, not to say illegally, with other people's credit and with their own. Probably most of those credit thieves do not repent at all. Instead, they have a complex series of self-justifications that let themselves off the hook. They need to be helped to see the error of their ways, and to see that they do owe restitution. But given the innate selfishness of such people, it's pointless to demand that they make a lot of personal sacrifices in order to make amends. They simply won't do it. Instead, efforts by people like Suze Orman or family members or friends hurt by these selfish people should be aimed at getting the offender to accept moral responsibility to repay the money, not through sacrifice, but through extra work. Work makes us feel good about ourselves; work is empowering. A person who is desperate enough to grab other people's credit or misuse their own to get what they feel they need will benefit from feeling more empowered by doing more work.  

I hope this woman comes to realize that her financial life does not have to continue to be a series of self-centered mistakes. It's too bad Suze may not have put her on the right track to squaring herself with those she has hurt. No matter how deeply we bury our sins, we know what we did. Atonement is a very significant act on the way to lasting self-esteem and honor. 

Medical Bills Can Be Discounted If You Pay Promptly

Many medical providers will give you a substantial discount if you pay within 30 days. It saves them the cost of trying to collect from you over a period of weeks, months, or years.

I thought I knew everything there was to know about paying medical bills until I got a call from a provider's in-house bill collector. At first I was puzzled, and then I realized that I had received that bill, put it aside, and forgotten to pay it promptly. The medical bill was for the balance due after my insurance company had cut the charges down to the contracted rate agreed to by the supplier, and then had paid its share of the remaining charge. The provider had already received a nice chunk of change, and I only owed less than 20% of what had been originally billed, but it still was nearly $500.

Nothing unusual so far. Many of us eventually get a bill for a remaining portion that our insurance policy does not pay. The big surprise was that once I'd finally located the bill, the bill collector voluntarily offered to cut the charge by 20% if I would pay it within 30 days. 

I had not said anything about having any difficulty in coming up with the money. I had not suggested that I make payments over time. I had not asked for a discount. The provider voluntarily offered me a discount that saved me just under $100. I don't know about you, but for me, saving that much was definitely worth five minutes on the phone. I could have paid the $500 invoice, but I am quite happy to have paid only $400 instead.

Since then I have learned that all medical providers do consider giving discounts. But you may have to ask. When you get a bill, call the number on it, and ask if they can give you a discount. If they refuse, say you'll then have to make payments on account. At that point, even the stubborn providers may grant you the discount, rightly fearing that you might never make all those payments, or any payments at all. It's very expensive to go after people for unpaid medical bills and in most circumstances the medical providers are not legally allowed to add interest or penalty charges to what you owe.

Try to make sure the discount is at least 20%, but let them suggest the number. They may give you an even bigger discount.

If your doctor wants you to have a test or procedure or even a visit with another doctor that your medical insurance will not cover at all, you can call that other provider in advance and explain, and ask for a discount. I once negotiated a test fee in advance down from $700 to $75 simply by asking. The doctor involved did it as a courtesy to the referring doctor, whom he admired. That was very generous, and considering my lack of insurance at the time, very necessary.

It also is not unreasonable to ask a provider who would have been paid by an insurer to accept that amount as payment in full. There are at least two versions: (1) The provider simply forgives the remaining balance, or (2) If you have no insurance coverage for that doctor, or service, you pay the provider directly an amount that is the same as an insurance company would have paid. For instance, if a doctor charges $120 a visit, but routinely only receives $64 from an insurer, plus a $15 patient co-pay, and your current insurance won't pay at all, you can ask to pay $79 a visit, which is all the doctor would get anyway. You have in effect received a 33% discount.

If you need to go out-of-network for certain specialists or tests, and your insurance company pays a smaller percentage of the charge, you should try this method. It never hurts to ask.

Why I'm a Suze Orman Fan

It's not that other people haven't personally given me good financial advice over the years. It's not that sensible financial advice isn't available from many sources and keyed to many education levels and social styles. The reason I'm a big Suze Orman fan is that her urgency about my future pushes me to care.

This is a big deal. She goes on PBS and begs us to get wills, trusts, durable medical powers of attorney, and living wills, and her urgency opens a pit in front of us that we have not wanted to face. Still don't want to face, to be honest. How many of us actually have wills? Living wills? Durable powers of attorney? What about trusts? How many times must we listen to her message before we act to protect ourselves? As many times as it takes, which is one reason Suze hasn't retired to spend the rest of her life boating. She knows we listen and then we do not act. So she keeps trying.

Suze Orman has gotten rich selling personal finance books and having her own television show, no question. But do I care? No one forces me to buy her books, and no one forces me to watch her on television, either. Sure, she "sells" a kit that contains the documents, too, as a gift if you donate to public broadcasting. I have compared her documents and they are word for word what appears in the same documents drawn up by a lawyer. Word for word.

I first remember encountering Suze Orman doing a PBS television show. Possibly I had by then read one of her books, but if so, neither the book nor Suze herself had made a huge impression. But she certainly did that night. She stressed how a comfortable life could be hugely disrupted simply by not having a few legal documents. She pointed out that because today people wear seatbelts in cars and cars have multiple airbags and other safety features, dying in a car crash isn't as likely as being very seriously injured. If that happened, what rights would my spouse have to direct my care, or to take over my share of our finances? None, without going to court.

Both questions are critical. I need a living will, so my spouse and everyone else will know what I want, and so my spouse can successfully direct my care if I become incapable of doing so. We all know what a mess some families get into when wishes are not known and family members fight amongst themselves. There also have been many cases of medical personnel overriding a person's wishes. In a living will, I can assign decision-making and make my wishes known. For instance, feeding tubes sound pretty nasty to me, but pain-relieving drugs seem like a good idea.  

The second point Suze made is just as important. If my spouse has my durable power of attorney, and I survive the car crash and the hospital but need to live in a different home, my spouse can sell our jointly owned home and buy a place with an elevator or a spa, or whatever I need. Or he could sell my car and buy a van with wheelchair or motorized cart assist technology. Or he could sell my stock and pay to have an elevator installed in our current home, and a wheelchair ramp to the front door. Without that document, he'd have to go to court to make each and every financial decision on my behalf, or get appointed my conservator, or take orders from someone else whom the court appointed. That nightmare can be avoided with a single document.

Despite her brilliant logic, it took me a long time to get both documents. Yet Suze has never backed away from urgently recommending them, and every time I've heard her do so, I've gotten that much closer to doing what after all is purely in my own self-interest. 

During the pledge break of that long-ago PBS show, Suze pleaded with us all to protect ourselves. The urgency of her message resonated with me, but I'm just as stubborn as the next person and it took me years to act. Specific advice she has given about saving and spending varies with the economy, but this chunk of advice is evergreen and clearly from the heart.      

That's why I'm a fan of Suze Orman. And that's why I, too, urge you to immediately get yourself the legal documents that will protect you and your loved ones in the event of a catastrophe.

If You are Unemployed, Apparently You Do Not Want to Work

Nina Easton writes on economic topics in Fortune Magazine. Seldom have I read as wrongheaded an understanding of the unemployed in our country than her recent article, "Time to Get Creative About Helping the Unemployed Back Into The Job Market" (Fortune, Feb. 3, 2014). If she had cited some ideas about helping unemployed people, I wouldn't have an issue with what she wrote. But she offers nothing creative or helpful. Instead, she cites statistics that are supposed to convince us that people who get food stamps and disability checks actually are healthy people who are lazy, who could find employment but choose not to. Since anything can be "proved" with statistics, I'm not going to argue with her claims. Instead I want to talk about what the poor and unemployed really are facing.

People on disability are not faking it. They have been broken by years of working physically damaging jobs, by factory accidents, and by chronic illness. Some of them can still walk without a cane, but most of them are not in any shape to work at any job. They're in constant pain, they're on medications that fuzz their brains, and they often can't see well enough to drive. The young ones have very obvious mental incapacity; if they are able to work, they do work in sheltered workshops. But they can't be expected to count your change at a Sheetz, and Walmart has eliminated greeters. These people as a group also lack education, which means they are unlikely to qualify for many jobs. Then the reality is that employers today very rarely make any accommodations for people with disabilities, despite the laws in place that are meant to help such people. Why should a chain restaurant hire a middle-aged server who has trouble walking when it can hire a healthy teenager or young adult? Why should a discount store hire a mentally challenged person who can't speak intelligibly and can't comprehend the employer's list of duties when there is a college graduate begging for the same job? In an economy in which the best and the brightest of our young generation are struggling even to find minimum wage work because there aren't good jobs for so many people, it does not matter whether the least educated and least healthy among us are trying to get jobs or not. They lose out because their competition is younger and more agile. 

 

Regarding food stamps, I don't like when well-fed individuals begrudge hungry people a meal, which is what cutting down or cutting off food stamps does. How does it hurt me if someone else eats? It doesn't. People who get food stamps use government money to buy food, which in turn supports many other businesses and means there are more grocery store jobs and trucking jobs--and farmers' crops don't go to waste. No one loses if people eat. If the argument is that an unemployed or underemployed person probably could pay for food, the reality is that if a person meets the government's rules for qualifying for food stamps, money is scarce. The money that has to be spent on food then can't go for rent, or for a car repair that could make it possible to get to a job. Food stamps also help keep children from starving, which is a noble cause. Food stamps are good. We should keep this program going until no one in America is hungry.

What about disability checks? Easton indignantly cites Lexington-Herald writer John Cheves' claim that disability checks yield "as much as $710 a month per person." That might sound like a fortune to an eight-year-old, but is a mere $8,520 a year. I defy anyone to loll in the lap of luxury on so little income. It divides out to $4.09 per hour if there is a 40-hour-a-week job available. Who can live on $4 an hour?

So how do the unemployed in our country survive? They live with relatives and friends, or they rent tiny apartments or government price-supported housing. Mostly, they depend on a  personal support system. People who move in search of work from a chronically depressed town whose factories have fled lose the very support system that sustains them, which is why they mostly do not move. Even supposing there are many jobs for which they qualify, we have plenty of statistics and history books to tell us just how miserable people are when they follow good jobs and end up living far from family and home. Remember the excesses of the Gold Rush? Rampant crime. Brothels. Suicide. Back when Detroit was a powerhouse, Bobby Bare had a popular hit with "Detroit City," a song about the loneliness of moving there to work one of those good factory jobs. The most telling phrase was, "I wanna go home."

In an increasingly connected world thanks to the Internet, it should be possible eventually for unemployed people living in depressed coal-mining towns in West Virginia to do work from home. Even low-skilled customer service representative work. What is the advantage to this? Why shouldn't they all move to city slums? The social fabric is not destroyed when people don't have to abandon their personal support systems to work. The result is less crime. More money is saved when people live in families, and if money is saved, more education dollars and discretionary dollars are available. It becomes possible to start a business, because there is seed money for it and other people in the area are employed also and thus have money to spend. That's my idea: The Internet is going to save us all. Maybe I'm right and maybe I'm wrong, but meanwhile, considering all the stupid ways our government wastes money, I'm okay with helping unemployed, underemployed, and disabled people keep up a basic standard of living. This is a rich country and we should spread the wealth to our people as they need it.

   

Can't Pay Your Medical Bills? Re-posting My Most Viewed Post

This is my most viewed post for a reason: Americans can't pay their medical bills. 

President Obama's Affordable Care Act, which took several years to implement, has already helped many people get access to health care and to affordable insurance. It will help more people in the future. That's great, because it means that you get medical care and you don't get skinned on the price of care. You just present your insurance card and you are guaranteed to not be held up in a big way for cash on the spot. But wait, yes, you still might be expected to fork over a co-pay. Oh. That's why this post is still relevant. Because many of us do not have the cash to pay our medical bills. Or, if we pay the up-front charge, we can't pay some other bill waiting at home, and we certainly can't pay the remainder of the provider's charges, often multiple bills that show up in the mail later.

Sure, Medicaid is an option. But what if you have medical bills from doctors who don't take Medicaid, or from times when you weren't on Medicaid, or from bills that Medicaid won't pay? And what about people whose income technically indicates that they can afford to pay for health insurance, but whose personal financial situation of being deeply in credit card or other debt means they actually don't have any money to pay their bills? Aha. There's the catch. 

Despite medical insurance of various stripes finally being available to us all, plenty of us still cannot pay the actual medical bills that eventually trickle or pour into our mailboxes. If we can't pay promptly, the phone calls start. Each provider or bill collector wants us to pay in full, and forget about paying anyone else or even having enough money to eat that month. Your immediate goal is to stop the provider from putting you into collection or initiating a lawsuit against you. Your financial goal is to pay the very minimum amount you can wrestle out of the provider and to only agree to a payment schedule you have a chance of meeting.

Here’s the basic scenario: 

1. Ask the provider to write off your portion of the bill after your insurance company has paid its share. Sometimes they will, if they’ve gotten enough from your insurer. Sometimes they will even if they’ve gotten nothing.

2. Negotiate the bill lower. Whether you have insurance or not, your goal is to pay between 5 and 50 percent of what you owe, max. Start your offer at 5 percent and let them negotiate you up. The main argument if you have insurance is they’ve already been paid a reasonable amount. The main argument if you don't have insurance that covered the procedure is they have billed you the utter maximum, and you want the bill to be cut to the remaining portion an insured person would be billed. Ideally, far lower.

3. Ask for a payment plan. By now they know you seriously care about the bill you owe, since you've talked to them repeatedly and maybe even called them on your own, trying to do something about paying it. They also know you can't pay it now. If they haven’t offered already, ask to make interest-free payments, stretched over a very long time. A year or more. These payments should give you space to recover first. Perhaps you can arrange to pay them a token fee now, or perhaps not. Then in six months, when you have regained your health, you’ll start making small monthly payments. Don't agree to a schedule that starts right now if you have no hope of meeting it. Try for delayed payments. Six months or a year later, if you still don’t have the money, try the scenario from the top, asking them to forgo payment entirely. Some dentists have payment plans that involve credit card companies and steep interest if you don't pay on time. Try to avoid this formal payment system, as it could drive you deeper in debt if you are short on cash.

4. Ask to be granted charity status. If you know you can never pay a medical bill---for instance, a hospital stay in the tens of thousands of dollars---present a written request on your own or ask to fill out their paperwork for being granted charity status. This is better than having a bill written off, which might produce tax consequences as supposedly "earned" income. When you know you can never pay, charity status is the way to go. You'll have to document why you are a plausible charity case, but most people who are in this situation have plenty of paperwork proving it already, and little shame or embarrassment about admitting that they're out of money. If one medical supplier grants you charity status, include a copy of that supplier's grant letter in your application for charity status to the next supplier. There are zero tax consequences to being granted charity status.

5. Speak to the doctor directly. Or write the doctor directly. If you like writing letters or aren’t afraid to ask your doctor in person, that’s a very effective method of asking for your bill to be drastically reduced or even entirely forgiven. The boss can do what the workers can’t.

6. Asking the doctor to cut the fee applies even to the co-pay. You'll probably never get a refund, so call in advance and ask in advance not to be charged the co-pay or the usual price of a procedure or visit about which you have advance notice. You can also write in advance, or have a negotiator (it could be a family member) call or write on your behalf. If you feel too ill to be up to these tasks, ask someone you know to help you. Usually an office manager will ask the doctor and get back to you with an answer. If it isn't the answer you like, and you have other options such as a different medical provider, pursue them.

7. If bill collectors do start calling, you have rights. The Federal Trade Commission has a great Consumer Information page that details the major rules under the Fair Debt Collection Practices Act. Best of all, you have the right to tell bill collectors to stop calling you. Check out the FTC page so you'll be aware of what debt collection practices are not allowed. Your state may have specific collection laws as well. Hopefully, they'll be in your favor. Most important, don't yield to the pressure that bill collectors exert. You know your financial and medical situation best, so don't agree to what they demand just to try to get them to stop calling. Use the method the law provides.

8. If you do get a notice that you're being sued over a medical bill, don't ignore it. Then you'll lose your chance to fight. You likely don't have the money to hire a lawyer, but you can call your local bar association to get the name of an attorney who will work for you pro bono--free. They do exist and it's not a big deal to find one. You qualify based on your lack of income or other circumstances. The important thing is to get legal representation, so a judge doesn't just take the medical provider's word for what you owe. After all, many medical bills are inflated, or duplications, or just plain wrong. If you miss your date in court, you automatically lose your case. By the way, even at this stage you can try to get charity status from the very same company that is suing you. You can ask your lawyer to send the medical provider a letter.

9. What if you've tried everything, and you still owe some monstrous bill from a hospital that insists you are rich and should pay? Ask for the surgical report on your procedure, which you have a right to by law, and/or whatever records or notes there are for anything, such as a hospital stay, an in-office procedure, anything. Have an unbiased medical professional review it for errors. Medical providers make mistakes all the time. If your records show that a mistake was made, or that something, perhaps an unexpected stay in ICU or some behavior that your medical consultant flags as not according to usual standards, suggests that you were not given correct care, then, with that proof in hand, it's time to call or write and suggest that you should not be liable for the bill because they made a mistake.


The mere whiff of a suggestion that there's a possibility that you might have a malpractice case (is that vague enough? because you are not going to call up and say "I'll sue you") will make the medical provider sit up and start thinking. You will get action. It is quite likely that the response will be a letter saying, no, no mistakes were made, but according to their records, you don't owe them any money.


Yes, this really happens. Medical providers are so afraid of being sued that the mere hint that you might possibly have a case against them may be enough to get them to "lose" your bill permanently.

Or, depending on what the records have revealed, you might be better off finding a contingency lawyer and suing. A mistake that worsens your health or puts your life at risk is an actionable event.

10. Sometimes the issue may be that a medical bill is incorrect, either for a large amount of money or for a smaller sum. As Jay Lake has discovered, some medical billing issues go around and around because the low-level employees of the medical providers and the low-level employees of the health insurance companies keep denying that they have any responsibility to resolve an error. They simply keep passing the buck. They'd rather you just paid what you do NOT owe than fix the error. Bill collectors often say the same thing: "Why don't you just pay it?" When that happens, it's time to tell your story to the local action line, time to file a complaint at the state level, and definitely time to contact your local legislative representatives and get some help. Nobody should pressure you to pay a bill you don't even owe. A pro bono lawyer should be able to cut through the nonsense in this situation, as well. 


The reality is that with or without insurance, any health blip can become a financial disaster. Although the new health care law will change many of these situations, here are some tools you can and should stockpile before the catastrophe:

1. Supplemental insurance. If you know you won’t have money to pay the remaining owed portion if you get seriously ill, buy insurance to pay that part. You’ve seen those TV ads for supplemental insurance; this is what they’re all about. When 80 percent coverage isn’t enough, there is a way to be insured to cover the other 20 percent. If you’ve got serious ongoing health problems such as heart disease or cancer, that additional coverage could be crucial. Those cheapie “we’ll pay you cash every day you’re in the hospital” policies may also help you out a little, but they’re unlikely to cover the enormous multiple expenses that can be incurred in just a one-day visit to the Emergency Room or the ICU.
2. Catastrophic health coverage. This is one of the cheap options of the ACA. Do not imagine that paying the federal fine for not having health insurance is cheaper than having insurance. The entire point of insurance is to cover you for catastrophes. Catastrophes happen to us all. You’ll have to pony up the first $5,000 or $10,000 before its benefits kick in, and, yes, you have to pay monthly premiums. It's insurance. It'll save you from having to pay $100,000 for a surprise stint in ICU.
3. State-funded health insurance plan based on your income or diagnosis. Some states have completely free coverage for certain diseases, such as HIV/AIDS, or breast cancer. Some states have coverage for people below a certain income. These vary by state, and some states aren’t generous. (A good reason to consider where you live based on state politics and resources.) Some states have expanded Medicaid under the ACA. Make sure you apply through the ACA portal, or you might get the runaround from old line Medicaid employees who are still existing on a parallel plane and apparently know nothing about ACA.
4. Social Security, either Disability or Supplemental. Either one will qualify you for a health insurance program (Medicare or Medicaid), but they aren’t easy to get. Disability is almost always an automatic rejection. There are companies and lawyers who will help you. Use them, as it takes years otherwise. The Social Security Administration posted a goal a while back of giving a first reply within 270 days. That’s a goal, not a track record.
5. Medical Billing Advocate. There aren’t a lot of these people around, but they’re pros at making sure you aren’t being overbilled by hospitals, labs, and doctors. They can bargain with your medical creditors to settle your medical bills for far lower than the invoiced amount.
6. Social Worker. There is a persistent myth that social workers actually exist who can help you and who want to help. Maybe when you’re trying to get public assistance, there actually will be a sympathetic social worker who wants to keep you from becoming homeless. Maybe not. Maybe there will be a hospital social worker who makes an effort to help you. Maybe not. At least while you’re waiting to see this probably overworked and burnt-out professional, you’re not at home stewing over bills you can’t pay, and you’re in a heated or air conditioned building, too, something that you might not have at home anymore.
7. Statute of Limitations. Perhaps you haven’t been able to access any of the prior listed methods of paying your medical bills. Each state has a statute of limitations on past due bills, and sometimes that’s only three years. Collectors are supposed to stop calling once you speak to them and ask them in writing to stop, but examples abound of collectors not acting in a legal manner. Put a stop to it. Three years of being called by bill collectors is probably enough purgatory for anyone. Tell any bill collector you no longer are legally liable to pay, and they must drop the case and stop calling. If they overstep their legal authority—which is a constant problem with bill collectors—report them promptly to the state agency that regulates them.

Of course the real answer to the problem of medical bills you can’t pay is to change our health care system at the core. We're on our way, but we aren't there yet.