Melanie Evans reports for the Wall Street Journal on the rise of hospitals requiring patients to pay upfront for their surgery. In one case, a hospital wanted $2,000 from a patient’s mother. It said it would postpone her daughter’s surgery if she could not come up with the money. While the patient is insured, she has a high deductible so her insurance would not cover the treatment.
The good news: If you have Medicare, you should never have to pay upfront for your care. Upfront payment issues are greatest for insured Americans with high-deductible health plans. That said, one recent study by the Consumer Financial Protection Bureau found that older adults owe $54 billion in medical debt.
Paying upfront is a challenge for millions of working Americans. In a Kaiser Family Foundation survey, half of adults said they could not pay an unexpected bill for $500 for their care without having to borrow money. GoFundMe is too often a solution. People do not have enough savings.
Some hospitals have essentially flipped the way they do their billing. Rather than waiting until after a procedure to bill a patient, they are refusing to perform the procedure without a payment in advance. They don’t want to be dealing with patients who won’t or can’t pay the bill after they have been treated.
Many people are in a bind, without the money they need to get care for themselves and their families. Sometimes they must delay critical care. Other times they find that the hospital overcharged them and need to spend their time getting the refunds they are due.
People giving birth, needing knee replacements and CT scans are increasingly being asked to pay in advance for these services.
Which hospitals are requiring these upfront payments? It appears that hospitals owned by UnitedHealth are among them. While hospitals cannot turn away patients who need emergency care, they can refuse to treat people needing elective care.
Today, hospitals collect nearly a quarter (23 percent) of patient bills in advance of treatment. That’s up from one fifth (20 percent) just two years ago.
Hospitals do not want to be forced to write off debt. And, even patients with insurance today are not able to cover their costs. Advance payments are how hospitals are getting around this issue to the detriment of many patients and their families.
Some claim the benefit to these upfront charges is that they let the patients know their costs so that they can possibly comparison shop. That is generally an impossible task, as it can mean switching doctors or traveling too great a distance to get needed care.
Before you pay a hospital bill upfront:
- Ask about other options. Non-profit hospitals must offer charity care for people who can’t afford to pay. Dollar For is a non-profit that can assist you in getting charity care.
- If the cost is high, ask whether there is a way to pay a lower price or to pay in installments with no interest.
Here’s more from Just Care:
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