Not all hospital visits are planned. And while the hospital staff usually tries to do their best to minimize surprises during treatment, surgery or a diagnosis, sometimes patients receive “surprise” bills. Here are a few tips on how to deal with — and better yet, avoid — these unexpected invoices.
So, what’s a surprise medical bill?
According to the Consumer Financial Protection Bureau (CFPB), “A surprise medical bill is an unexpected bill, often for services received from a healthcare provider or facility, that you did not know was out-of-network until you were billed.” The CFPB points to services such as anesthesiology or laboratory tests as potential line items that can lead to unexpected expenses.
The good news is, there are some tools that can help. For one, the No Surprises Act protects insured patients from the following:
- Out-of-network charges for supplemental care from providers that treat patients in an in-network facility
- Out-of-network cost-sharing for both emergency and non-emergency treatment
- Emergency treatment from an out-of-network provider or facility that didn’t have your prior authorization
If you’re uninsured, the health-care provider must give you a good faith estimate prior to care. This estimate should include a detailed list with specific charges you can expect from the treatment. Also, the provider must present this in a way that’s accessible to you.
Also, according to the Centers for Medicaid and Medicare Services, if your bill is $400 or more above the good faith estimate, you might be able to dispute the cost at CMS.gov.
Save money for medical emergencies.
Even if you’re covered under the No Surprises Act, you may still face high medical bills. As with most unexpected expenses, it’s important to have a cash reserve.
When it comes to medical costs, if you’re insured, a good rule of thumb is to look at the maximum out-of-pocket expenses according to your benefits. If your out-of-pocket expenses are $5,000, then reserving $5,000 in your savings account might be a good idea for “just in case” situations.
Additionally, some companies offer employees special accounts as part of their benefits package to help cover medical expenses — both planned and unplanned. Specifically, you could have a Health Savings Account (HSA) or Flexible Spending Account (FSA). The type of account you’re eligible for would depend on the type of insurance you choose and your personal circumstances.
The money is often deducted directly from your paycheck — sometimes as a tax-free advantage. You may also be able to make deposits into these accounts from a personal bank account. Terms (like deposit limits and accepted expenses) and eligibility vary, so your best bet is to ask your employer for more information about their specific choices.
Surprises don’t have to happen.
As you’re facing a medical issue, the only thing that should be on your mind is your health. To avoid further stress, open communication with the health-care provider can also be an important step when it comes to medical expenses.
Before, during and after treatment occurs, review all your bills to make sure you’re paying only for services rendered. Also, if you do a bit of overall financial planning regularly, you’ll be better prepared for any unexpected bill that shows up.