July 2008
What you can do
Once you've paid an out-of-pocket medical bill with a loan or credit card, you lose your ability to negotiate the repayment
amount and terms. Here's what you need to know:
- Hospitals are required by federal law to provide care in a medical emergency. Always ask for an itemized bill and check it
for accuracy, because billing errors are common, according to the Access Project, a national health-care consumer advocacy
group based in Boston.
- If you can pay at the time of service, providers may be willing to cut your bill by more than 50 percent to avoid the expense
of billing. When negotiating discounts or any payment terms, ask to speak to the manager of patient accounts. Get any agreements
in writing.
- When you're dealing with a hospital, request a copy of its financial assistance guidelines to see whether you qualify for
free or discounted care. Although non-profit facilities are supposed to volunteer such help, consumer advocates report they
often don't inform patients about these options unless they're asked.
- Providers generally structure plans to be paid off in no more than 24 months, but negotiate a longer term if necessary to
ensure that you will be able to afford the monthly payment, because your account can be sent to a collection agency if you
are paying less than the agreed-upon amount. Any interest charged is likely to be at a lower rate than a commercial lender's.
- If relying on credit is your only option, shop for the best general-purpose credit card deal rather than take a health-care credit card or loan marketed through your doctor or hospital. Zero-interest offers are a good deal only if you're absolutely sure that you will be able to pay the balance in full during the interest-free period. If you can't be sure you'll be able to pay on time, Curtis Arnold, founder of CardRatings.com, suggests putting medical charges on one of your existing credit cards and then transferring that balance. Among the best deals recently available: Blue or Blue Cash from American Express, which both offer a 4.99 percent rate for the life of the balance with a 3 percent transfer fee, and Pentagon Federal Credit Union's 2.99 percent rate for the life of the balance with a 1 percent transfer fee.
