Patient’s guide to financial assistance for medical bills

The stress of carrying medical debt can be overwhelming. Taking steps to pay off that debt can help. BuoyFi offers simple tools for finding affordable settlement and payment plans. Many patients also qualify for financial assistance programs that can prevent, reduce or eliminate the burden of medical debt for uninsured or underinsured patients. So what programs are available to you from healthcare providers, non-profit organizations, and federal and state governments? Let BuoyFi be your guide.

What is charity care?

When searching online, you’re likely to uncover a variety of medical debt assistance programs. Some may help cover co-pays, deductibles, and other out-of-pocket medical expenses. Others may help with negotiating medical bills, designing payment plans, or accessing loans or grants.

Charity care is defined by the Internal Revenue Service as free or discounted health care services. It is offered to people who meet the healthcare provider’s eligibility criteria for financial assistance. Charity care covers “medically necessary” treatment, including inpatient hospital stays, routine preventative care, and emergency medical visits.

Non-profit hospitals (nearly 58% of community hospitals) are required to offer charity care to qualified patients to maintain tax-exempt status. Often funded through donations and grants, charity care programs are provided based on the patient’s assets, household income and the federal poverty guidelines.

Hospitals have different eligibility criteria for charitable care, but they are required to:

  • Post a notice about their charity care policy in the emergency room, admissions area, and the financial service or billing areas.
  • Give a patient charity care information at intake or discharge
  • Post a plain language summary of the hospital’s current charity care policy and the application form on the hospital’s website
  • Provide the summary and application in all languages spoken by more than 10% of the population served by the hospital
  • Give a patient charity care information in every billing statement
  • Provide all billing statements and written communications in both English and the second most spoken language in the hospital’s service area

Unfortunately, not all hospitals meet their obligations to provide this information. Be sure to ask and do your research to access all the help paying hospital bills that you qualify for.

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How do financial assistance programs help the uninsured and underinsured?

More than 43% of working-age adults in the U.S. are underinsured, and nearly 12% are uninsured, according to The Commonwealth Fund. Medical assistance programs help close that gap by providing access to healthcare services to individuals and families who cannot afford everyday services. Other ways financial assistance helps the uninsured and underinsured include:

  1. Providing guidance through the complexities of applying for government programs
  2. Helping ensure individuals receive the maximum benefits for which they are eligible.
  3. Promoting preventative care, including wellness check-ups, vaccinations, health screenings, and more. Catching illness early not only gives a person the best chance for a full recovery, but it is also almost always less expensive than providing treatment after you are sick.
  4. Educating individuals on how to reach attainable health goals access affordable healthcare services.
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Who qualifies for financial assistance for hospital bills?

Financial assistance is available to more than those who are underinsured or without insurance coverage. Eligibility for medical debt programs is typically based on an individual’s overall financial situation, including their household income, savings, and expenses. Low income families, generally those earning below 400% of the federal poverty level (FPL), may qualify for free or discounted care.

Eligibility guidelines vary by program, organization and state and local laws, so make sure you’ve done your research before applying. Nonprofit hospitals are required to provide this information.

Start by asking for a copy of the healthcare provider’s financial assistance policy and ask how long your application might take to process when submitted. Remember that the Affordable Care Act requires hospitals with 501(c)(3) nonprofit status to provide free or discounted care to qualifying patients. Many pharmaceutical companies also offer prescription medication at deep discounts for individuals dealing with chronic diseases and similar medical conditions, like IBD, cancer, and mental illness. There is often a patient advocate on the healthcare provider’s financial services team that can help you navigate the financial assistance application for their organization and for any pharmaceutical company assistance programs.

If your medical debt is already with a collection agency, you may still be eligible for help. BuoyFi offers a suite of tools to help you determine, based on your household income, potential eligibility for debt reduction or forgiveness, and affordable settlement options to help you negotiate your debt with collections agencies or care providers.

Reach out to your provider or a BuoyFi financial counselor for information and help. 

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What’s the difference between nonprofit and for-profit hospital systems?

As the name suggests, for-profit hospitals provide services to patients with a primary goal of making a profit. Nonprofit organizations may earn a profit for their services, but the profits cannot be distributed to private interests or individuals.

The Affordable Care Act requires nonprofit hospitals provide free or discounted care for qualifying patients. Federal and state laws help determine how much each nonprofit’s budget must be used for charity care.

For-profit hospitals are not required by law to provide financial assistance to patients who are unable to pay medical bills. However, many for-profit hospitals do offer financial assistance or charity care to patients in need. Some states require for-profit healthcare systems to enact some form of assistance program. Those states include California, Connecticut, Illinois, Maine, Maryland, Nevada, New Jersey, New York, Rhode Island, and Washington.

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How to apply for financial aid for medical bills

There are a few standard steps everyone should follow when applying for medical bill financial assistance. They include:

  1. Contacting your healthcare provider – Ask if they are a non-profit and request information on their financial assistance programs.
  2. Reviewing eligibility requirements – If your care provider provides information on hospital bill assistance programs, make sure you review any eligibility requirements attached to the program. Do you meet the criteria? If so, ask for information on how to apply.
  3. Collecting personal information – Standard information most financial assistance programs ask for includes proof of income, prior year tax returns, and medical bill details. Missing information can delay approval of your application. Some programs may deny assistance if you do not have the required information.
  4. Filling out the application – If you’re confident you have all the information you need, fill out your application. Most likely the application will be available online. Note that some programs require speaking with a representative prior to or during the process.
  5. Following up – It’s helpful to reach out to the care provider after submitting your application to ensure it was received and will be processed. This will give you peace of mind that you’ve taken your first steps toward solving your financial challenges.
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Where to go for help

Healthcare providers, community organizations, patient assistance programs, governments, and financial aid service organizations can help ease your financial burden. BuoyFi will assist by helping you calculate how much medical debt you can afford to pay, recommending personalized plans to help you take the first step toward financial freedom, and providing you with the financial tools to avoid future debt.

If your situation requires expertise beyond what BuoyFi can offer, consider one of these organizations. Each provides a way for individuals and families to address their healthcare needs financially.

  • Medicaid: The U.S. government’s healthcare program for low-income individuals and families. Medicaid covers the cost of medical care for eligible individuals, including hospital visits, doctor’s appointments, prescriptions, and more.
  • Medicare: Federally funded healthcare program for individuals aged 65 and older. Individuals with certain health challenges or medical conditions may also be eligible.
  • Patient Access Network Foundation: PAN Foundation helps underinsured people with life-threatening, chronic, and rare diseases get the medications and treatments they need by assisting with their out-of-pocket costs and advocating for improved access and affordability.
  • HealthWell Foundation: Provides financial assistance to individuals with chronic or life-threatening illnesses looking for help with hospital bills.

Across the U.S., organizations are working toward an easier to navigate, more affordable heath care system. Until then, financial assistance programs are here to bridge the gap.

If freeing yourself from medical debt seems impossible, know that there is a way out. Download the BuoyFi app or set up an online account today to calculate a personalized and affordable settlement and payment plan and get the assistance you deserve.

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A path toward financial freedom

The high cost of healthcare is a burden on many families and many organizations are working to make the system more affordable and easier to navigate. While approaches to solving the problem of high healthcare costs differ, one thing people across the spectrum seem to agree on is that people should not be bankrupted with overwhelming medical debt. If you are in a situation that feels hopeless, know that there is a way out.

Download the BuoyFi app or set up an online account today to calculate a personalized and affordable settlement and payment plan to rise above medical debt.