I used an ACA policy to erase over $1,000 in medical debt
- I received a $1000 medical bill which was more than I expected, but I knew the ACA might be able to help me.
- The ACA requires nonprofit hospitals to provide financial assistance programs to patients in need.
- I qualified for the plan (earning a middle class income) and saw my entire bill wiped out.
A few years ago my then husband broke his hand in an unfortunate accident.
As her fingers began to swell purple, we rushed to the hospital. We had health insurance through the Affordable Care Act, but our co-pay for emergencies was still absurd. We had to pay at least $500 for this visit.
Doctors determined that the damage was not going to be healed by a cast, so they wrapped him in bandages and braces and discharged him.
When we got the bill, it turned out there was a total of $1,000 in charges that the insurance wouldn’t cover. The $500 deductible plus an additional $500 in medical expenses.
A Little-Known ACA Policy Helped Me Clear Our Medical Debt
After my initial panic, I looked at the hospital’s financial aid policy. Through my work in personal finance, I knew that if a hospital was a nonprofit, it had to offer financial assistance under the ACA—a benefit that many people are unaware of.
We were insured. And at the time, we were pretty close to the average household income. I didn’t know if we would qualify. The ACA does not have specific guidelines regarding income and asset limits with respect to these programs. The hospital is required to offer a program, and it should advertise its program to its patients, but the actual operation of the program depends almost entirely on the institution itself, depending on state law. In Pennsylvania at the time, there were no other rules for the hospital to follow.
When I looked at the income limits, I breathed a sigh of relief. For a household our size, we could get 100% forgiveness. But you have to work for it. We must have collected all our W2s for several years. Our household expenses like rent were factored into the equation and the paperwork required as well. I collected them all, filled out a four-page form showing our overall financial picture, and mailed it to the address listed.
About a month later, we learned that the debt had been 100% forgiven. I’ve since used this same program in an emergency room in California, at specific doctor’s offices that were closely associated with a nonprofit hospital, and for a bout of strep throat that kept me in the emergency room. overnight.
How to Use the ACA Financial Aid Program
You can also use these programs. First, make sure the hospital you are visiting is a non-profit hospital. If they are, they are legally required to offer any of these programs and legally required to advertise them to you.
Some hospitals don’t do so well on this second part. If you do not see the financial aid plan advertised, you can request information at admissions. Or, when you receive your bill, there should be a phone number listed somewhere on it that will give you more information about the financial aid policy.
If your hospital can’t even do that, call the billing department directly and explicitly ask about the financial assistance program. Try to do this within 30 days of your visit, as you don’t want to risk the bill getting caught in collections.
Next, know that while there are no income limits set by the federal government, each hospital can write their own. This might put you off, thinking that only low-income or uninsured people are eligible for these programs. But in every case I’ve seen in my personal experience, that couldn’t be further from the truth.
Even as an insured family with a solid middle-class income, we have repeatedly qualified for 100% discount in multiple programs in multiple states.
The ACA is a flawed compromise that does not do enough to help the average American household deal with the exorbitant costs of our healthcare system. But it’s also the only reason millions of Americans can access insurance and offers little-known patient protections in certain circumstances, like with financial assistance plans at nonprofit hospitals.