Should I pay medical bills up front?

Question

After a recent accident and hospitalization, I am starting to get bills for the full amounts of my medical costs. It's like the hospital, doctors and ambulance don't even want to wait for my insurance to pay. They virtually say, "Pay me first, then you'll get reimbursed by your insurance." I've used my medical insurance before this for routine doctor visits and only had to pay a small deductible and no one ever asked for up-front payments. A friend advised me not to pay anything, but I know she's in debt and in collection up to her ears (but this doesn't seem to worry her - it would me), so I'm not sure her advice is trustworthy. I don't want to get put in collection. I asking a broader advice base. Any suggestions? Thanks.

Answer 1

When you say accident, I'm assuming you're referring to an automobile accident. If this is the case, the coverage provided by your, or any, auto insurance will be primary over your health insurance. Some health insurance companies will refuse to pay in cases like this unless they have information  stating the auto insurance coverage has been exhausted.

If the accident was YOUR fault, simply send the bills to your insurance carrier so they can start paying them up to your policy limits.

If the accident was SOMEONE ELSE'S fault, you'll be waiting on a settlement for a little while. You should be fine to go ahead and pay them until you get reimbursed from the other insurance company. But even in this situation, you should be able to file a claim with your own auto ins. carrier and let them pay the bills until you reach a settlement with the other carrier....at which time, they would reimburse your insurance the amount they paid out.

Answer 2

If you are receiving bills for the full amount, the providers may not have gotten your insurance info and are billing you. Contact the providers and make sure they have the info-then in a couple weeks, contact your insurance and make sure they have the bills and ask if the providers are "in-network". If you were not given a choice of what hospital and doctors were to treat you, since this was an accident and an emergency situation, they should be paid as in-network, but clarify that right away. They should be able to tell you at that point, how long it should take for payment to go out to the providers and for you to recieve the explanations of benefits from your insurance telling you how much you owe the providers. Once you determine what you will owe the providers, contact the providers for payment arrangements or pay the balance in full if you can. If the bills are not paid in 60-90 days, you need to contact the insurance again, since this is the point where some providers turn accounts over to collection-but you should recieve a final bill before that happens.

Answer 3

Depends. If you are seeing a participating provider for routine stuff, this is probably covered. The hospital, ambulance and some of the doctors on the hospital staff may not be on your insurance's list of providers. Hence, you will not, or only partially be covered. Best call your insurance company and ASK them DIRECTLY what they will cover and if you should pay up front. Good luck.

Answer 4

It really depends on what state you are in.  Some states carry Personal Injury Protection coverage where you either have to opt out of it or it is mandatory.  Others may have what is called Medpay.  This is completely optional.  You should definitely look at your insurance policy and see what you have.  Personal Injury Protection coverage can be considered primary to pay for her medical expenses while Medpay can either be primary or secondary to her own health insurance.  Look at your insurance policy and it will explain what it covers and if it is primary or not.  If nothing else, you do pay a premium so call your insurance carrier for assistance.