5 Tips for Understanding Medical Bills

Around 54% of insured Americans are often confused by medical bills. At some point, everyone will have to understand a medical bill. Maybe you had an accident or an unplanned surgery, or perhaps a loved one passed away, and you’re dealing with their final expenses. Whatever the case, you’ll need to understand what all those numbers and terms mean to ensure you’re not overpaying – or worse, getting saddled with debt you can’t afford. Below are some tips for understanding medical bills that can help you prepare for future health care costs.

1. Clarify What You’re Reading

A medical bill can be confusing, but it’s essential to take the time to review it carefully. Make sure you understand each charge and check that the costs are accurate. If you don’t understand something, don’t hesitate to ask your doctor or the hospital billing office for clarification. For instance, if there is a medical or health term you don’t recognize, look it up online or ask your doctor what it means. Some standard terms you might see on a medical bill include co-insurance, co-pay, deductible, and out-of-pocket maximum.

2. Get an Itemized Statement

Getting an itemized statement is one of the best ways to understand medical bills, as it provides a more detailed picture of the care you received and how much it cost. If you have insurance, your insurer will likely receive a summary bill from the hospital that outlines the total cost of your care. However, you should also request an itemized statement from the hospital that lists each service you received and the corresponding charges. Once you have this information, you can compare it to the summary bill to ensure there aren’t any errors.

3. Check the Dates

When reviewing a medical bill, check the dates to ensure that you’re only being charged for services you received. You might see a service listed that you don’t remember, which could be an error. If you think there is an error, contact the hospital billing office and ask for an explanation. The dates can help you understand which care you are being charged for. You should also check that the dates match up with the dates of your insurance coverage. For example, if you had a procedure done before your insurance policy went into effect, you may be responsible for the entire procedure cost.

4. Know Your Insurance Coverage

One of the best ways to avoid being surprised by a medical bill is to know your insurance coverage ahead of time. Make sure you understand your policy’s deductible, co-insurance, and co-payments. Call your insurance company and ask if you don’t know this information. It’s also important to know what health services your insurance policy covers. For example, if you’re planning to have a baby, you should check to see if your insurance policy covers prenatal care, labor, delivery, or postnatal care. With 20% of children aged five to 11 having at least one untreated decayed tooth, it’s also good to know if you qualify for dental insurance. By knowing what services are covered, you can budget for any out-of-pocket costs that may come up.

5. Review Your Senior Living Home Costs

It’s also a good idea to review your costs if you’re a senior living in a retirement home. Make sure you understand the monthly fees and any additional charges for services such as laundry, transportation, or meals. Sometimes, these additional services can be bundled into one price, so asking about this upfront is essential. Other times, you might need to pay for services separately. For instance, 55% of assisted living communities offer mental health services, but these services may not be included in the monthly fee.

If you’re a senior on a fixed income, it’s also essential to know if your costs will increase over time. Some retirement homes have ‘tiered pricing,’ meaning the monthly fee goes up as you age or your care needs change. Make sure you understand how the pricing works to budget accordingly.

Understanding medical bills can be challenging, but knowing what you’re being charged for is important. By following these tips, you can be sure that you’re getting the care you need at a price you can afford.


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