My father who has conjestive heart failure and type 2 diabetes recently underwent a quintuple heart bypass. His medical bills are staggering and he has no health insurance. Short of filing bankruptcy, what are his options in getting these amounts reduced?
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Insurance Lawyer
Jeffrey Johnson is a legal writer with a focus on personal injury. He has worked on personal injury and sovereign immunity litigation in addition to experience in family, estate, and criminal law. He earned a J.D. from the University of Baltimore and has worked in legal offices and non-profits in Maryland, Texas, and North Carolina. He has also earned an MFA in screenwriting from Chapman Univer...
Jeffrey Johnson
Insurance Lawyer
Jeffrey Johnson is a legal writer with a focus on personal injury. He has worked on personal injury and sovereign immunity litigation in addition to experience in family, estate, and criminal law. He earned a J.D. from the University of Baltimore and has worked in legal offices and non-profits in Maryland, Texas, and North Carolina. He has also earned an MFA in screenwriting from Chapman Univer...
Jeffrey Johnson
Updated July 2023
You could offer to pay immediately at the same discounted level those bills would have been paid by a health insurer (Blue Cross and HMO have agreements with the hospital and medical/surgical providers to substantially discount bills). That’s a very substantial discount from the full “list price”.
If that offer is not accepted, when he is sued, he might be more successful by saying the discounted price is the “reasonable and customary” price, rather than the list price they are seeking to collect. This approach is based on the fact that the discounted rates are what they receive on the majority of payments. He could do extensive pre-trial discovery to make them disclose their actual reimbursement rates (they would likely settle rather than disclose).
This whole process could be handled far better with the help of an attorney.
Case Studies: Exploring Options for Reducing Medical Bills Without Health Insurance
Case Study 1: Reducing Medical Bills Without Health Insurance
John’s father, who suffers from congestive heart failure and type 2 diabetes, recently underwent a quintuple heart bypass surgery. With no health insurance, the medical bills have become a significant financial burden. John wants to explore options to reduce these bills without resorting to bankruptcy.
Case Study 2: Negotiating Discounted Rates for Medical Bills
Sarah’s mother underwent an emergency procedure, resulting in substantial medical bills. Sarah wonders if she can offer to pay immediately at the same discounted level that health insurers typically pay. She hopes to leverage existing agreements between hospitals and insurers to significantly reduce the outstanding amount.
Case Study 3: Challenging the Reasonable and Customary Price
Michael faces a lawsuit due to unpaid medical bills resulting from his recent medical treatment. He believes that the discounted rates negotiated by health insurers should be considered the “reasonable and customary” price. Michael plans to argue that the list price being sought for collection is inflated and not representative of the actual reimbursement rates commonly accepted by healthcare providers.
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