For many consumers, paying their medical bills is a stretch.  One in three Americans has trouble with that, according to a recent analysis by researchers at the Kaiser Family Foundation and the Georgetown University Health Policy Institute. It affects people with insurance as well as those without, and people with a wide range of incomes can be overwhelmed by hospital bills.  [Kaiser Health News is an editorially independent program of The Kaiser Family Foundation.]

Medical debt is worrisome and embarrassing, but more importantly, it can have long-term financial consequences.

Here are some tips that may be helpful to avoid or alleviate medical debt:

— Try to talk to your doctor or hospital before being treated to find out what the services will cost and how much your insurance will cover. Don’t be afraid to tell the provider that you don’t have the money up front and try to work out ahead of time a payment plan for your share of the bill. Estimate your ability to pay honestly so that you don’t find yourself responsible for monthly payments you cannot cover. Both insured and uninsured patients can sometimes qualify for programs to help with the cost of their care.

— When negotiating a price with your doctor or hospital, ask if they will accept the price that Medicare pays for the treatment. That can be considerably cheaper than the price they offer individuals.

— Check your bills carefully. Make sure the charges are for care you actually received and no mistakes were made.  A Commonwealth Fund study found that in 2010, about 9 million people were contacted by a collection agency because of a billing mistake.

— Watch your mail for the “explanation of benefits,” or EOB, from your insurer. It is often the most reliable way to know what you owe.

— Make sure that the bill from your hospital or doctor includes payments made by your insurance company. If the provider’s bill doesn’t jibe with your EOB, check with the insurer. Perhaps that company still has its portion to pay or there is some problem with the bill the insurer received from your doctor that can be remedied to reduce your charges.

— If you bought a silver plan on the online insurance marketplaces set up under the health law, see if you qualify for cost-sharing subsidies. Those may help bring down your out-of-pocket expenses. 

— Be careful about paying for your medical debt with a credit card. They can often have very high interest rates that may make the debt even more difficult to pay off. Also, be careful about accepting a doctor’s offer of a credit card to put that debt on. Some of those cards have come under scrutiny for fraudulent practices.  

— Don’t hesitate to ask a family member or friend to help you understand the bills. Patients can often be too sick to make the calls and do the research needed to stay on top of the billing. Ask someone you trust to give you a hand.

— If you need other help, many states have consumer affairs offices or the office of the state attorney general may have information or resources than are helpful to patients facing debt concerns.  Non-profit counseling services and the state-based civil legal services offices may also be helpful.

Sources:  Washington Law Help.org, The Wisconsin Department of Health Services, The National Foundation for Credit Counseling, The Kaiser Family Foundation, The Commonwealth Fund, The American Academy of Family Physicians.