Nearly $54 billion. That’s the amount of unpaid medical bills older Americans were carrying in 2020 – an increase of 20% from the year before. Another eye-opening fact? Among the nearly four million older adults with medical debt, nearly all of them reported having health insurance. While anyone can have medical debt, those more likely to be affected include older adults of color and older adults with low income.
Shouldn’t health insurance prevent medical debt? Meet Mary S. Daniel, a Board-Certified Patient Advocate who specializes in medical billing and caregiving advocacy and who is a nationally recognized speaker who frequently addresses this topic.
Even if you have Medicare or an employer-sponsored health plan, you still may be responsible for out-of-pocket costs like co-payments, coinsurance, deductibles and out-of-network surcharges. These costs can add up fast, especially if you have a chronic condition, serious illness or disability. A single unexpected crisis, such as a car accident or bad fall, can plunge a person into debt quickly. In fact, most medical debt is due to bills from a one-time or short-term health care expense.
Billing errors make older adults even more vulnerable to medical debt. Older people are more likely to have greater chronic health needs, which translates into a more complex billing process. This often leads to mistakes, such as the wrong parties being billed or providers seeking inappropriate reimbursement. Once an insurer rejects a claim, providers often continue to pursue patients for payment instead of fixing the error and resubmitting the claim. If patients don’t recognize their bill is inaccurate, unchecked errors can result in a snowball of medical debt that soon becomes unmanageable.
“Communication is very important. Ignoring the debt won’t make it go away…”
Mary S. Daniel, Board-Certified Patient Advocate
“It’s critical that you closely check and monitor your medical bills for any fees charged that don’t match the explanation of your care and benefits,” says Jennifer West, a Jacksonville-based medical billing specialist. “Time is of the essence, so if you see anything that doesn’t add up, contact your provider or its billing agency quickly. If you’ve tried but been unable to get a clear explanation or resolve your billing issue, it may be time to reach out to a medical debt advocate or attorney.”
Negative impact on credit score: If they go unpaid for a certain length of time, your medical bills can wind up in debt collection. Once that happens, you may be subject to unpleasant calls from debt collectors demanding prompt payment.
What is a Patient Advocate and How Can They Help You?
Daniel says most patients seeking medical care don’t have the knowledge needed to understand our complex process and it’s easy to get intimidated and accept the “no’s” the system is always giving us. Her work includes the management of bills for a chronic illness, the negotiation of large bills if faced with a catastrophic event, and getting authorization for services that may be denied by your insurance company.
“Hiring an advocate allows an expert to navigate options so you get the very best care. Services can include making doctor’s appointments, accompanying the patient to the appointment, asking questions of the providers, assistance in understanding medical bills and even prescription reviews. Patient advocates come from various medical backgrounds including nurses, pharmacists, medical practice administrators, or medical billing professionals who put their expertise to use helping others understand the medical system they know,” Daniel said.
The first step Daniel recommends is to always talk with the provider. Many offer financial assistance programs that will reduce and many times eliminate the debt completely. “Communication is extremely important. Ignoring the debt won’t make it go away, talking to the provider about your individual situation always allows for a better outcome,” said Daniel. You can find more information at MarySDaniel.com.
Photo Credit: Kampus Production
