How to Dispute and Pay for Large Medical Bills

doctor getting ready to give a shot

Astronomical medical bills can be devastating to any budget. Here’s how to dispute and pay for large medical bills in six easy steps.

Review your bills

Typically, you’ll receive an Explanation of Benefits (EOB) from your insurance company in addition to the actual bill telling you how much you’re responsible for paying. It’s important to hold onto both of these documents and review them carefully.

The EOB is a document provided by your insurance company explaining your insurance benefits as it pertains to a bill. If a procedure or treatment is not covered, the EOB should include a short explanation about why it’s not covered. Review your bills to make sure the EOB and the medical bill correspond with each other. If there is a discrepancy between the two documents, it may be a billing error.

If your bill includes charges for COVID-19 testing or related expenses, like copayments and deductibles, your insurance should be covering the entire amount, as per the Families First Coronavirus Response Act.

Review your insurance coverage

Familiarize yourself with your health insurance policy before disputing any charges. Most health insurance providers offer all members a detailed manual outlining which treatments and charges are covered and which are not. Here, you can refer back to the EOB to see if the insurance paid for all procedures it claims to cover.

Dispute all errors

If your insurance billed you incorrectly or did not pay for a procedure or treatment that’s allegedly covered under your plan, call a company representative to ask about the charge. Be sure to have your bill in front of you and to record all details of the conversation for future reference.

If the error is with your doctor’s office, ask to speak to a representative of the billing office to explain your position and keep a careful record of the conversation.

In both cases, be prepared to make multiple phone calls until you reach a party who can actually authorize changes. You can also follow up with a written request to challenge a charge.

Negotiate the remaining bill

Consider negotiating with the billing office at your doctor’s practice for a lower bill. Explain you’re having difficulty paying your bill and you’re looking for a way to lower the costs. With luck, you’ll walk away with a discounted bill.

If you believe a charge for a procedure has been unreasonably inflated, research the going rate of coverage through sites like HealthcareBluebook.com and myHealthcare Cost Estimator.

Create a payment plan or seek funding

Once you have your final bill amount, you may choose to create a payment plan to spread the bill over several months or years to make it manageable.

If your doctor’s office insists on immediate payment or the monthly payments aren’t manageable, consider taking out a personal loan. This would provide you with the funds you need to pay your bill immediately, and with a payback plan that won’t break your budget.

You could also consider opening a Home Equity Line of Credit (HELOC) which would allow you to tap into your home’s equity and use the cash to pay your medical bills.

Going forward

To avoid a large medical bill in the future, consider switching your insurance plan to one that provides more coverage and less expensive copayments and deductibles.

Another long-term option is setting up a Health Savings Account (HSA). An HSA is designed for people with a high-deductible health care plan. The funds you contribute are tax-deductible, grow tax-free and can be withdrawn to cover qualified medical expenses.*

It’s important to make sure everything is billed correctly on your medical bills. It’s equally important to set up a repayment option that best fits your budget. If you need additional help with your budget, we've partnered with GreenPath, Inc., a non-profit, financial wellness organization that provides support and education for our members. Services include debt counseling, debt management, credit report review and more. Click here for more details.