What if a law is passed but nobody enforced it? This is essentially what happened to a small but helpful rule about hospitals and financial assistance for medical bills.
The Affordable Care Act, also known as Obamacare, requires nonprofit hospitals to provide financial assistance to low-income patients and to post these guidelines online. In the USA, More than half of the hospitals are non-profit – and in some states all or almost all hospitals are nonprofit. But many people who are eligible for financial assistance – or “charity” as it is sometimes called – never apply.
Jared Walker helps spread the word. He founded Dollars for, an organization that directly helps people use hospitals’ financial support policies to pay unaffordable medical bills. Walker caught public attention earlier this year through a viral TikTok he turned a lark one night.
By doing 60 second video, Walker outlines the basics of applying for hospital financial assistance in response to a prompt asking TikTokers to “share something you’ve learned that feels illegal.”
“Most hospitals in America are nonprofit, which means they must have financial support or charity policies,” he says in the video. “That will sound strange, but it means the hospital will have to legally waive your medical bills if you make less than a certain amount of money.”
The video outlines the basics of applying for hospital charities, which he uses to “crush” medical bills.
“One arm and one leg”Reports a podcast on the cost of health care about Walker and his Work of the organization since the video’s viral moment, as well as the decades-long battle to establish charity rules that preceded it.
Here are five strategies that Walker endorses and shares during the monthly volunteer training sessions:
1. How do you find the guideline?
Walker’s trick to finding a hospital’s funding guidelines is as simple as it gets: Google it. Enter the name of the hospital followed by “Grant Policy” or “Charity Policy”. The initial search results are likely to be a draft policy and an application to be submitted.
Your first instinct might be to go to your hospital’s homepage. But that’s probably a mistake. According to Walker, guidelines are usually hidden in the menus of hospital websites. In many states, charity laws are more specific than those described in the ACA, and hospitals may need to make their financial assistance policies clear.
It rarely happens that the guidelines aren’t available online at all, but in some cases, Walker said, you may need to call the hospital and file a claim.
2. Who is qualified?
Most hospital charity policies are income based and use percentages of the Federal poverty guidelines Define suitability. In one example, Walker showed the guidelines for St. Luke’s Hospital, Kansas Citywhere patients who earned 200% of the federal poverty guidelines accounted for 0% of their bill. That number was just over $ 2,000 per month in 2021. Those who earned 201% to 300% were eligible for certain discounts.
Not sure how your income compares against the federal poverty guidelines? Here is one of many helpful online calculators. Remember, your household is made up of you, your spouse, and anyone you claim to be dependent on your taxes. Roommates don’t count.
Documents to prove your income are usually required for applications. According to Walker, hospitals require things like updated pay slips, proof of unemployment, social security premiums, and tax returns. The documents the hospital can ask for can vary. But a hospital cannot refuse you if you fail to provide a document that is not listed in the application.
3. In collections? Maybe you still have time.
the IRS Requires nonprofit hospitals to give patients 240 days (approximately eight months) grace from the first invoice date to apply for financial assistance. But hospitals are allowed to send invoices to debt collection agencies much earlier – often after 120 days.
At this point, patients often feel haunted by debt collection agency notifications. However, patients may have months to apply for financial assistance, and notifying collection centers that an application is being processed by the hospital can sometimes stop the letters.
“The hospital can take you out of collections as easily as they can take you there,” said Walker.
In some cases, hospitals will waive bills that are much older than 240 days. If in doubt, applying for invoices that are several years old can also be worthwhile, Walker said. It doesn’t hurt to ask for help.
4. Looks like you don’t qualify? Write a letter.
If you can’t qualify based on income alone but still can’t afford your hospital bills, don’t exclude yourself. The same applies if the hospital’s subsidy scheme stipulates that only uninsured persons are entitled to benefits; You may have insurance but are still looking at huge bills that you can’t pay.
Walker said a letter about financial difficulties attached to an application can help. In fact, he encourages every patient to enclose a letter, no matter how strong his request appears.
“These are real people reading this, and the letters go a long way,” he said. Ultimately, each hospital decides who gets the help that it is legally required to provide. Make your case.
5. Yes, you may need to fax it in.
While many hospitals have digital portals to enable online bill payment, there is usually no equivalent for applying for financial aid. Many applications only offer a postal address. However, Walker and his team have found that applications sent through the mail are often lost.
Instead, they recommend either going to the hospital and handing it over or faxing it. Public libraries, packaging stores like FedEx, and certain online services make faxing possible even if, like most people, you haven’t used a fax machine since the late 1990s.
When it comes to getting charities, “you have to jump through a lot of hoops,” said Walker, “but it’s worth it.”
Emily Pisacreta is a reporter and producer for “One arm and one leg“, A podcast produced jointly with KHN on the costs of health care.
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