Medical debt is a serious issue in the United States and one that is, unfortunately, getting more serious over time. The truth is that everyone in this country has the potential to accumulate medical debt at some point in their lives. However, there are situations in which they rightfully have to pay and other situations in which the bill should not be their responsibility for a variety of reasons.
In this country, there are several different types of bills and several different ways in which medical debt is billed.
- Balance billing: This occurs when the health care provider sends the bill to the patient after the patient’s health insurance has paid whatever they are going to pay. The balance bill is the difference between what the provider charges and the amount that the insurance company agrees to pay. That is after copays, coinsurance and any deductible. This type of billing can also occur if the patient goes out of network, which means that either the provider is out of network or the medical facility is out of network. In-network providers take whatever the insurance company gives them and they don’t balance the bill. On the other hand, out-of-network providers do not have such an agreement with the insurance companies. In many cases in the past, out-of-network providers would bill the patient for the amount that the insurance company didn’t pay. Interestingly, neither Medicare nor Medicaid allows balance billing.
- Surprise billing: This type of billing happens when a patient is billed after being treated by an out-of-network provider or an out-of-network facility. An example of that would be a hospital. It can happen as a result of emergency and non-emergency situations. There are some states that have protections in place against surprise billing. It is important to note that if the person has a self-insured health plan, which applies to a large percentage of the people who are covered by their employer. Currently, there are some federal laws that are also designed to protect consumers.
How does the government protect me?
The federal No Surprises Act was designed to protect you against emergency out-of-network medical bills and nonemergency services that may be necessary at an in-network facility. The No Surprises Act has been in effect since 2022 and is currently being enforced in Indiana. You must be informed of your rights under this law from your health plan and from the providers and facilities that treat you.
Protecting yourself against overwhelming medical debt
There are many different ways that you can handle medical debt. One of the ways is filing for bankruptcy. If you decide that you want to do that in order to get out from under crushing medical debt, a knowledgeable Indiana bankruptcy attorney can make a tremendous difference to your case and can help you to understand and protect your rights so that you can start over fresh and look forward to a brighter future.