We’ve all become accustomed to checking out the sale racks when we’re shopping for clothes or trying to talk down the price of that great chair at the local flea market. When it comes to medical bills however, we often assume that we have no choice but to pay the full fee. That is not necessarily the case. If you’re willing to advocate for yourself, it may be possible to work out an agreement with your doctor or hospital to cut the cost of medical treatment.

If you were to come to the MAP office with very large hospital bills, we would try to help you negotiate a reduction in your out-of pocket medical expenses. There are many ways to do this; here are a few:

• Offer to pay your doctor a discounted amount in full. Doctors and hospitals often prefer to have a bill settled than to deal with payment plans that drag out over time. (A bird in the hand can be worth two in the bush.) If you can’t afford to put out the cash all at once, charge it — but only if you’re sure you’ll be able to pay off the debt over time.
• Don’t put the bill on your credit card and then try to negotiate a reduction later on. At that point it will be too late.
• Talk directly to your doctor — or the hospital billing officer. He or she is the one who will ultimately decide. Making a personal appeal is often much more effective.
• Many hospitals offer charity care, and it can be worthwhile to look into it. Even if you’re middle class, you can make the argument that the medical bill is so high relative to your income that it will be impossible for you to pay it off in full. Documenting your expenses can help to support your case. You may be able to negotiate a payment plan that’s within your means.
• Some medical expenses can be prevented, or reduced in other ways. If you have health insurance, make sure that everyone involved in your care participates in your plan, and don’t just assume that a recommended treatment will be covered by your insurance.
• Read your plan carefully to see just what it does and doesn’t cover, and how much of the cost will be paid. And bear in mind that most insurance policies have caps on the amount that will be paid within a given year or over the course of a lifetime. Unnecessary expenses, and billing errors, can reduce the amount available to you when you really need it.
• Always make sure your bill is accurate. If there’s anything you don’t understand, you can ask for an itemized bill, and check it to see that you’ve received all the services you’re being charged for. Request your medical records if you’re at all unsure. Mistakes do happen, and they can be quite costly.
• If you are unexpectedly hospitalized, and you don’t have insurance, you might be eligible for a government program. Be sure to let hospital staff know you need to apply for it. There will often be an office on site that can help you with the forms.

If you don’t have health insurance to begin with, you should first consider trying to get on the Local 802 health plan. This involves making your gigs union and having your bandleader or employer contribute into the plan on your behalf. Contact the Organizing Department at Local 802 at (212) 245-4802, ext. 191 or 186. If this won’t work for you, call the MAP office for other options.

If you do find yourself caught unprepared with medical bills you can’t manage, there are a number of charitable organizations that help musicians in need. Call the MAP office for assistance, or for more information about anything discussed in this article.

Leslie Cardell is a Licensed Clinical Social Worker and the coordinator of Musicians’ Assistance Program services. MAP office hours are Monday, Wednesday and Friday from 9:30 to 5. Call (212) 397-4802 for an appointment.