If you get a bill from the doctor, do you have to pay all of it? Maybe not…
The office of the Musicians’ Assistance Program is your one-stop shop for musicians’ health. We offer counseling – both one-on-one and in groups – as well as information on all kinds of social services, including health insurance, food stamps and more. All services are free to Local 802 members. Contact us at MAP@Local802afm.org or (212) 397-4802.
The cost of medical care in this country is daunting as well as complicated. If you are not insured, the thought of incurring a large medical debt is truly frightening.
It’s clear that a long-term solution would be some kind of national health insurance program that everyone could get for free or for cheap.
Another solution is the Local 802 health plan. Call the organizing department at (212) 245-4802 for more information.
Finally, if you are completely uninsured, call my office to find out about options for musicians.
However, let’s say the worst has happen: you’re uninsured and and you have to go the hospital.
Once you’re recovered, but before you leave the hospital, ask to talk to the hospital social worker or someone in the billing department. Explain that you are uninsured and ask about any government programs that are available to you.
But let’s say that you’re not eligible and that you later receive a huge bill in the mail. What can you do?
First, look at the bill carefully. Make sure that all charges are correct. Be sure to check for:
- Duplicate charges
- Charges for procedures not performed
- Medications not received.
If you find an error, it is your right to question the bill and have it corrected before proceeding with payment options.
Once you have determined that the bill is correct, call the billing office and tell them you’d like to apply for charity care. Explain your profession and your financial situation. The hospital will likely require that you show documentation, establishing your inability to pay. Bring your documentation to the hospital billing office, clearly presenting your situation in a letter, with the stated request that your bill be totally forgiven. If they refuse that request, follow up by asking for a 50 to 70 percent reduction, with a reasonable payment plan.
(For other medical bills, the procedure is similar. Explain your financial situation, offer to document it and request that it be forgiven or reduced.)
If you have insurance coverage, you should always receive an “Explanation of Benefits” statement from your insurance company showing what was paid to the provider and the amount for which you will be responsible. This is not a bill; the bill will come from the doctor or other service provider. Do not pay the provider until you receive an actual bill. Many times, they will accept the amount that the insurance company paid and won’t bill you. If the provider does bill you, call and ask if they’ll accept what the insurance company has paid and forgive the balance, again explaining your professional and financial situations.
Talk directly to your doctor or the hospital billing officer. He or she is the one who will ultimately decide what you will be responsible to pay. Making a personal appeal is often much more effective. Keep a written record of all phone calls include the date, the name of person with whom you spoke and notes on what transpired.
For planned treatment, explore your options. Prior to receiving treatment, shop around. Be direct with your health care provider and ask if there are less expensive, medically sound options available. Read your plan carefully to see just what it does and doesn’t cover, and how much of the cost will be paid. Make sure that all costs are factored in such areas as nursing care, anesthesia and the facility cost. If you have health insurance, make sure that everyone involved in your care participates in your plan, and don’t assume that a recommended treatment will be covered by your insurance. Keep 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.
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. If you can’t afford to put out the cash all at once, you can consider using a credit card but only if you’re absolutely sure you’ll be able to pay off the debt over time. This type of arrangement will prohibit you from negotiating a lower fee later on!
It can be challenging to negotiate on your own behalf. Sometimes, it’s easier to negotiate when it’s not for yourself. If you would like help, please contact the MAP office at (212) 397-4802 or MAP@Local802afm.org and we will be happy to help you through the process.
This story originally appeared in the September 2011 issue of Allegro, the magazine of the New York City musicians’ union (AFM Local 802). For reprint requests, send an e-mail to editor Mikael Elsila at Allegro@Local802afm.org.