Medical Debt for DC Residents

Know Your Rights!

Don’t let medical debt prevent you from getting the care you need.

By law, hospitals cannot turn you away from the emergency room. If you ask for financial assistance, the hospital cannot deny you further care while determining if you are eligible for financial assistance.

Check that your medical bills are accurate.

Before paying your medical bills, look them over closely to make sure your name, insurance information, address, and the treatment you received are correctly listed. Ask for an itemized statement if you did not get one, and ask for a plain language explanation for anything on the bill that you do not understand.

You should make sure that the prices stated on your bill are not more than those stated in the hospital’s “standard charge” list, which each hospital has to post online. Find the standard charge list online, then search the code numbers, names of services, and amounts on your bill to make sure the charges in your bill match the standard charge list. Contact us for help with this.

If you see any errors on your bill or a charge for a service that is very unreasonable, contact your healthcare provider to learn more and resolve the issue.

Check that your insurance processes your claims correctly.

If you have insurance, your insurance company will send you an “Explanation of Benefits (EOB)” statement. This document describes how much the hospital or health care provider charged for providing medical care, how much your insurance will pay, and how much you will have to pay. You should look at this document to make sure all the charges match your medical bill.

If you see any errors on your explanation of benefits, contact your insurance company. You can appeal decisions by your insurance company to not pay for a service you needed, but make sure to do it as soon as possible and before the deadline. Your Explanation of Benefits statement should include information on how to appeal the decisions in the statement.

Request financial assistance from your healthcare provider.

Nonprofit hospitals are required to offer financial assistance, such as free or reduced-price care for eligible patients. Each hospital has its own eligibility requirements, but patients are generally eligible if they cannot afford their medical bill, request assistance, and make less than 200 percent of the federal poverty level. Nonprofit hospitals must have their written policies and information on how to apply for financial assistance available online and in paper copy at the hospital.

Review your provider’s financial assistance policy to see if you are eligible and if your treatment is covered. If so, collect the required information and documents and complete the financial assistance application. Feel free to call the provider’s billing office with any questions. Apply for financial assistance as soon as possible since most programs require you to apply within 240 days of treatment.

If your application for financial assistance is denied, follow any appeals process the hospital has within the required timeframe. Some for-profit hospitals also have financial assistance programs. You can check their policies to see if you are eligible for financial assistance and apply. You can also try to work out a payment plan with your provider, but do not agree to a payment plan that you cannot afford.

Consider applying for health insurance.

Consider applying for health insurance through Medicaid or DC Healthcare Alliance. DC has Retro Medicaid, which will cover medical bills from the past three months before applying. Undocumented individuals can consider applying for DC Healthcare Alliance, which provides health insurance for people who are not eligible for Medicaid. Learn more and apply online.

If you do not qualify for Medicaid or DC Healthcare Alliance, you might be able to find affordable health insurance coverage through DC Health Link, the DC health insurance marketplace under the Affordable Care Act.

Don’t pay medical debt before other types of debt.

If you have other debts, medical debt can be a lower priority. The major credit reporting agencies have agreed not to list any medical debt under $500 on credit reports and not to report higher medical debts for one year after payment is past due. This means missed payments for medical debt will not immediately negatively affect your credit score. Missed payments on rent or mortgage might lead to you losing your home. Missed payments for a car note will not only negatively impact your credit score but could also lead to your losing vehicle. Missed payments on credit cards will immediately and negatively impact your credit score.

Further, you should not put medical debt on a credit card. Medical debt typically carries low or no interest or late charges, unlike credit card debt. Turning medical debt into credit card debt will also eliminate the possibility of negotiating with your healthcare provider for lower bills.

Know your rights dealing with debt collectors.

Some hospitals or providers may hire debt collectors to collect your debt. They may also sell your debt to a debt buyer. If you are being contacted by debt collectors, you have the right to request that they verify the debt. It is important that you send a letter asking for the debt to be verified within 30 days of the debt collector first communicating with you.

Sample letters are available through the DC Office of the Attorney General website and the Consumer Financial Protection Bureau website. Further, debt collectors cannot harass you, and you have the right to tell them to stop contacting you through a written letter (though doing so will not eliminate the debt and may make it more likely that they will file a lawsuit against you). Sample letters for that are also available through the DC Office of the Attorney General website and the Consumer Financial Protection Bureau website.

Know your rights handling your credit report and score.

Healthcare providers generally do not report unpaid medical bills to credit reporting agencies, so most newer medical debt does not affect your credit score. However, once a hospital turns over your medical debt to a collection agency, that debt may negatively impact your credit score. Your credit report and what is on it is what can make or break your credit score.

You have the right to look at your TransUnion, Equifax, and Experian credit reports for free once per year through AnnualCreditReport.com. If any listed medical debts on your credit report are wrong, you have the right to fight them. If medical debt is not showing up on your credit report and you haven’t gotten any recent mail about it, contact Tzedek DC to talk about what your next steps should be.

TransUnion, Equifax, and Experian have stopped reporting any medical debts under $500. If you have a medical debt under $500 that is still on your credit report, you can dispute it or contact us.