For many people, the COVID-19 pandemic struck at the worst possible time: when they or a family member was already sick. That could make medical bills much more difficult to pay.
“We’ve had a lot of crying families where they’ve lost jobs," said Carrie Keneipp, manager of Family Financial Advocates at Cincinnati Children’s Hospital Medical Center. "Or, because they’ve lost the job, then they’ve lost their insurance.”
Keneipp said they have seen a 350% rise in need for assistance since the pandemic began. These are families that have needed to access help from the hospital's Charitable Care Fund, which relies on donations from outside sources.
“(Families are) also dealing with the burdens and stress of financial medical bills, medicine that’s super expensive or equipment that their child needs,” she said.
Meanwhile, some experts predict the medical bills of those diagnosed and treated for COVID-19 will be difficult to pay for many individuals and families.
The CARES Act included a $100 billion Provider Relief Fund. That money and other funds in the act will allow uninsured COVID-19 patients to now have their tests and treatments covered in most cases. That means healthcare providers are able to apply for federal reimbursements.
However, patients who have health insurance but are under-insured or have high deductibles and co-pays could find themselves saddled with high medical bills, especially if their care involved a long hospital stay with ventilation.
“The debt of COVID-19, there’s so many mixed signals about, are we going to be charged?” said Craig Antico, founder and chief operating officer for RIP Medical Debt, a national nonprofit that buys and pays off medical debt for people who can't afford it.
“The insurance companies are also giving mixed signals," Antico said. "Some say, we’re not going to charge deductibles. Some say we’re not going to charge any co-pays. But, you don’t know unless you call your insurance company.”
Some inpatient hospital bills could range from $9,700 to more than $20,000 for employer-covered insurance, according to an analysis produced in March by the Peterson Center on Heathcare and the Kaiser Family Foundation. The research is based on comparable care for patients being treated for pneumonia.
Antico said his company paid off $1.4 billion in medical debt in 2019. Usually by the time they purchase the debt it is in the collection phase.
“The people that owe the debt that we’re buying probably could only pay maybe three percent of it," he said. "So, we pay about one percent."
Meanwhile, Antico offered a number of tips for people who know they may not be able to pay their hospital and medical bills.
Call the hospital if you can’t pay
"Call the hospital immediately,” Antico said. “And say, we’ve lost income here. We don’t have income. He was the only, or she was the only, breadwinner of the family.”
He said in most cases the hospital or medical practice will be willing to put you on a lower pay schedule.
You may qualify for full coverage of your hospital bill
“A third of the population makes less than two times the federal poverty level,” he said. For example, a single person making $25,520 per year, or a family of four making $52,400 per year, is at 200 percent of the 2020 federal poverty level.
“If you’ve gone to the hospital and didn’t know that there’s a financial assistance for that hospital, because all of them have it," Antico said, "you call them up immediately and say, 'I qualify for charity care,' if you make less than two times the poverty level.”
Negotiate your hospital bill
If you don't qualify for charity care, you can discuss ways to lower your bill with the billing department.
“Every single bill is negotiable. And especially these COVID bills will be negotiable,” he said.
The idea is not to allow medical debt to create a financial hardship.
“You could make $70-80,000 and if you’re spending 10 percent of your gross income on medical out-of-pocket expenses, you are in a hardship,” he said.
Only pay 3% of your income to out-of-pocket expenses
“You’re putting yourself in harm's way and you’re hurting your family if you don’t go by that rule," said Antico. "So if you make $1,000, you can only pay $30 a month.”
He said he understands people want to pay their medical bills, but they have to be able to pay for their essential needs as well.
“This is not something you should be ashamed about," Antico said. "It’s just the cost of care is so high, that normal people can’t pay it without hardship."
Ask for an itemized bill
According to Antico, an itemized bill should show a detailed breakdown of charges.
“It’ll show here’s the rack rate or the charge master," he said. "Here’s the discount, which is the discount that comes to the usual and customary. Here’s what you’re responsible for."
There are some circumstances where you can negotiate lower charges if you know what other hospitals in the area are charging, he said. That would involve finding out the billing codes for certain procedures to determine if there is a difference between what you have been charged and what other hospitals in the area charge.
Understand the usual, customary and reasonable rate
This is the amount medical providers in a geographic area typically charge for a medical service. Insurers will usually agree to pay a percentage of this amount of the bill. But the rest may be left to be paid by the patient.
“It’s not like you’re getting a discount on your $500 bill to $250, when the usual and customary bill is $150,” Antico said.
Meanwhile, Keneipp said there are a number of resources they can access locally and nationally to help families. They want them to focus on the health of their children. Currently, Cincinnati Children's is accepting donations to its Charitable Care Fund for families in need because of the pandemic. Jergens Hand Care is offering to match up to $10,000.
“We’re here to help the families try to relieve some of that financial burden,” she said.