Q. We experienced some unexpected medical issues this year. The medical bills continue to roll in. We have health insurance, but we are still struggling to pay all our bills. What can we do?

A. First, know that you are not alone. According to the 2017 study, Gender Gap in Financial Outcomes, the Impact of Medical Payments, 1 in 6 families experiences an extraordinary medical payment in any given year. It can take more than one year to fully recover from this medical event. The study describes an extraordinary medical payment as a payment over $1,000.

As you know, even with health insurance, a family can end up owing a significant amount of medical debt, due to deductibles, co-pays, and unallowable charges. It’s easy to feel overwhelmed, but don’t let this keep you from taking action.

First, gather all of your medical bills. Make a comprehensive list or create a spreadsheet to see what you owe and to whom. Next, gather all the benefit reports from your health insurance company. Compare your medical bills to the insurance company’s statements showing the amount each provider was paid. If you have questions relating to what your health insurance company has paid, call them and ask for an explanation. If you have a question about what was sent into the health insurance company, you need to contact your medical provider for an explanation on this, too.

Many medical providers are willing to work with patients and their families on medical bills. They just need you to communicate with them and make payment arrangements. You need to propose a reasonable payment amount, and you need to be able to make the payment each and every month. To know what you can afford, you may need to review your income and expenses. Can you make reasonable payments based on your current budget, or do you need to make cuts in your flexible expenses so you can afford to pay your medical bills? While we do not plan on getting hurt or ill, we are grateful for the medical treatment we receive. It would be unreasonable to expect a medical provider to accept a $25 a month payment while we pay $100 for cable, eat meals out, or spend money in others we can reduce.

Some medical providers may ask you to fill out a financial form before they are willing to accept monthly payments. If you are unable to pay the bill in full, and you request to make payments, you are essentially asking your medical provider to extend you credit. Therefore, having you fill out a form stating the terms of your agreement is a reasonable request.

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Once you agree to make a monthly payment, you are making a promise to your medical provider. This means that you won’t be able to skip a payment any time, including during the holidays when cash gets tight.

If you don’t make payment arrangements and ignore the bill instead, your bill will likely be turned over to a collection agency. You want to avoid this because a collection agency may be less likely to accept monthly payments or may be more difficult to work with.

As with all debt, ignoring the situation will not make it go away. Take the initiative to develop a plan to address all of your debt. Little by little, you will chip away the debt and gain a whole lot of freedom in the process.

Bonnie Spain is the executive director of Consumer Credit Counseling Service of the Black Hills, a United Way member agency. To contact her, email credit@cccsbh.com

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