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How to pay huge medical bills on a small income

Woman visiting a doctor
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Medical debt can put a serious strain on your finances, particularly if you’re living on a small income. Even if your insurance covered a sizable chunk of the treatment costs, it’s possible to be stuck with medical bills you can’t afford to pay and face collection actions from hospitals and medical providers.

But you’re not alone. In 2020, collection agencies held a whopping $140 billion in medical debt, according to the American Medical Association. This figure is up roughly $60 billion from 2016.

If you can’t afford to pay your medical bills, you could be forced to deal with debt collectors, and your credit score could take a hit. Fortunately, there are ways to cope with substantial medical bills on a small income and avoid severe financial consequences.

How to pay huge medical bills on a small income

1. Ensure charges are accurate

Billing mistakes are bound to happen. So, it’s essential to review your explanation of benefits (EOB) forms and billing statements to make sure you actually owe the amount you’re being charged for services. If you notice unauthorized charges, duplicates or medical codes you’re unfamiliar with, call the hospital or medical provider’s billing office to discuss your concerns and request an adjustment to your bill.

It’s equally important to confirm that you were only billed for charges that aren’t covered by your insurance policy. Refer to your policy documents, and if you notice charges for items that should’ve been paid, reach out to your insurance provider for clarity.

2. Ask about a discount and negotiate the payment amount

Once you’ve confirmed the amount you owe, contact your medical provider’s billing office and ask for a discount. If you didn’t have insurance at the time of treatment, the charges are likely higher as they were probably billed at a steeper rate. But you may have luck negotiating reduced fees for services, especially if you remit payment in a lump sum. Another way to possibly get a discount is by offering to pay in full within a 30- or 60-day period.

If you haven’t yet received services and are worried about costs, try contacting the medical provider’s office now to express your concerns. You could get a reduced rate that’s slightly more affordable by simply asking for a discount. Also, consider referencing the Healthcare Blue Book that includes average service costs for hospitals and doctors nationwide. This information can help you negotiate more effectively and plead your case for lower rates on medical services.

3. Set up a payment plan

If you’re unable to secure a discount or can’t afford to pay the reduced bill in full, request a payment plan. Many medical providers offer interest-free payment plans that allow patients with limited incomes to stretch out the payments over an extended period.


The provider may allow you to pick a payment amount that works for your budget or request financial information to calculate a monthly payment. The latter is an income-driven hardship plan and may result in a portion of your medical debt being forgiven. Some medical providers also offer a flat-rate discount if you agree to make a down payment between 10 and 30 percent on the bill.

Be mindful that interest-free payment plans only work if you have the means to uphold your end of the bargain. Otherwise, you should seek other forms of financial assistance to help cover your medical bills. More on that shortly.

4. Find financial assistance

Contact the hospital or medical provider’s billing office to inquire about financial assistance programs you may qualify for. They’re readily available at nonprofit institutions for patients who are low-income or plagued by financial hardship.

For-profit entities don’t always offer these programs. However, they could refer you to organizations in the community that can assist through grants that forgive a portion or all of your medical bills if you meet the income eligibility criteria.

Also, consider applying for Medicaid to curb future medical costs. It’s a form of coverage funded by federal and state governments and caters to low-income individuals and families. While you can’t retroactively apply the benefits to your existing medical bills, you can avoid incurring high medical bills that you’re responsible for going forward.

Other forms of financial assistance that can help reduce large medical bills going forward include:

  • gov: use this tool to identify federal and state-sponsored healthcare and medical assistance programs you may be eligible for
  • CancerCare: offers financial support for costs and copayments related to cancer treatments
  • Children’s Health Insurance Program: provides medical and dental coverage for minors (up to 18 years old) who are uninsured
  • HealthWell Foundation: features disease funds that provide grants to patients who are unable to cover the cost of medical treatments and other healthcare costs, including deductibles, premiums, copayments and supply expenses
  • Leukemia and Lymphoma Society: offers an assortment of financial support services and grant programs to help individuals who’ve been diagnosed with blood cancer
  • Nationally Organization for Rare Disorders: provides financial support for medical expenses not covered by insurance for individuals with certain rare diseases
  • Patient Access Network Foundation: features patient assistance programs that financially support individuals living with chronic or rare diseases
  • The Assistance Fund: helps cover the cost of speciality prescription medication, insurance premiums and copayments

5. Look into medical credit cards

Medical credit cards let you cover the cost of medical treatment and often come with an introductory interest-free period spanning six to 24 months. So, you can get the care you need without worrying about hefty medical bills.

If possible, try to pay the balance in full before the promotional interest term ends. Otherwise, you could be on the hook for hundreds or thousands in interest, especially if you’re only able to make the minimum monthly payment on the credit card.

6. Consider a personal loan

A personal loan should only be used as a last-ditch effort to cover excessive medical bills. It gives you a lump sum payable with interest over a set period. If you borrow a large amount and receive a short repayment term, the monthly payments could quickly stretch your budget too thin. And if your credit score is on the lower end, you’ll likely get a high interest rate and spend a fortune in interest over the loan term.

7. Contact a medical bill advocate

If you’ve exhausted all your options and need professional help resolving your medical debt, a medical bill advocate can assist. These individuals specialize in working directly with medical providers on the patient’s behalf to reach a fair payment plan that works for both parties. If there are billing discrepancies, medical bill advocates can also file appeals with the medical provider to ensure the billing statements accurately reflect what you owe.

8. Contact an attorney

Should you be unable to come to a resolution with your providers, contact an attorney who specializes in bankruptcies to learn what other options you might have available. An attorney can help you determine whether a negotiated settlement or a bankruptcy would be in your best interest. Either way, the lawyer can keep the uncooperative providers from suing to collect and help avoid possible wage garnishment or bank levy.

Written by
Steve Bucci
Credit and Debt Expert Contributor
Steve Bucci has been helping people decode and master personal finance issues for more than 20 years. He is the author of “Credit Management Kit For Dummies,” “Credit Repair Kit For Dummies,” “Barnes and Noble Debt Management,” co-author of “Managing Your Money All-In-One For Dummies” and “Debt Repair Kit For Dummies” (Australia). Steve is an experienced expert witness in identity theft, credit scoring, and debt-related cases. He has been a presenter at the FICO InterACT Global Conference, the Federal Reserve and the International Credit Symposium at Cambridge University in the UK.
Edited by
Loans Editor, Former Insurance Editor