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You do not have to pay yet.
And you do not have to do this alone.
An appeal can take months, and the bill does not wait. This area covers what to do about the bill in the meantime, how to get it reduced whatever the appeal decides, and where to find a person who does this for a living.
What do you need to do?
- Handle the bill while you appeal Ask for a hold, check the bill against your statement, and avoid paying what you may not owe.
- Get a hospital bill reduced Apply for hospital financial assistance and negotiate what is left.
- Deal with medical debt and collections Know your rights when a bill goes to collections or appears on your credit report.
- Find free help State consumer advocates, Medicare counselors, federal advisors, nonprofits and legal aid, by coverage and state.
- Decide whether to pay for help What paid advocates, appeal services and lawyers do, what they cost, and what to ask first.
- Help someone else with their denial Get permission to act for a parent, partner or child, and what a doctor's office can do for a patient.
Tools for this step
4 4 tools
Free, no account, nothing leaves your browser.
- Authorized representative helper
See what permission you need to act for someone else and build the letter that names you.
Tool
- Bill and statement reconciler
Put your bill next to your Explanation of Benefits and see the mismatches to question.
Tool
- Find help near you
Pick your state and coverage and see the regulator, the free consumer program and the Medicare counselors for you.
Tool
- Hospital financial assistance check
See whether it is worth applying for hospital financial assistance, count the 240-day window from the first bill, and see what to ask the hospital for.
Tool
Start with
16 16 guides
16 guides in this area
- Guide
Help with drug costs
Two different problems get mixed up: your plan will not cover a drug, or you cannot afford your share. Fix the first with an exception or appeal, and look at nonprofit directories for the second.
- Guide
Medicare counseling through the State Health Insurance Assistance Program
Every state has a free Medicare counseling program that is not tied to any insurance company. Here is what it does, how to reach it, and when to call 1-800-MEDICARE or a quality improvement organization instead.
- Guide
What a state consumer advocate does
Some states run or fund free consumer advocates who explain your plan, write appeals and push back on insurers. Here is what three of them do, and how to find out what your state offers.
More guides 13
- A bill is not an Explanation of Benefits: do not pay yet
A provider's bill and your plan's Explanation of Benefits are different papers. Match them before you pay, ask for a hold in writing, and do not pay what your plan may owe.
- Acting for someone else
You can usually help a parent, partner or adult child with a denial if they give written permission. Here is how to name a representative with plans, Medicare and Medicaid, and what this page does not cover.
- For clinicians' offices: supporting a patient's appeal
A short guide for doctors and office staff. Learn when to ask for a peer-to-peer call, which letters to write, how to certify urgency, and what the patient needs to file their own appeal.
- Good faith estimates for people paying themselves
If you have no insurance, or choose not to use it, you are entitled to a good faith estimate. If the bill comes in $400 or more over it, you may be able to dispute the bill.
- Hospital financial assistance
Many hospitals will reduce or cancel a bill for people who cannot afford it, whatever your insurance appeal decides. Here is how to find the policy, apply, and keep your deadline.
- How to negotiate a medical bill
You can ask a provider to lower a bill. This page shows the order that works best: check the bill, ask for financial assistance, then make a written offer and get the agreement in writing.
- Legal aid and when to hire a lawyer
Free legal aid helps some people with health coverage, Medicaid and medical debt. A lawyer matters most for a hearing, a lawsuit against a plan, or a debt lawsuit. Here is how to find one and what to ask.
- Medical debt and your credit report
Unpaid medical bills can end up on credit reports. Here is how to check your reports, dispute mistakes in writing, and where to confirm today's rules, which are set by federal and state law.
- Medical debt in collections
A medical bill in collections can still be questioned. Confirm it is real and yours, check it against your insurance paperwork, answer in writing, and see what help is still open.
- Paying for an advocate or an artificial intelligence appeal service: what to ask
Paid advocates, artificial intelligence appeal services and lawyers do different jobs. Check free options first, then ask who does the work, what they need, how they use your data and how they measure results.
- Payment plans and medical credit cards
A payment plan spreads a bill out but does not make it smaller. Here are the questions to ask a provider, or a lender that offers a medical credit card or loan, before you sign anything.
- The bill while you appeal
Appeals take months and the bill keeps coming. Ask the provider for a hold in writing, check the bill against your Explanation of Benefits, and do not pay what your plan may still owe.
- Where to get free help, by coverage type
The right free helper depends on who regulates your plan. Here is a map from job-based, Marketplace, Medicare, Medicaid and military coverage to the people who can help at no cost.
Letters, checklists and programs
37 37 items
- The bill while you appeal
How to keep a bill from getting worse while your appeal is pending, check what you actually owe, and look for ways to reduce it.
Checklist
- Ask a collector to validate a debt
Ask a collection company in writing to prove what it says you owe, and to pause collection while you appeal and check the bill.
Letter or script
- Ask the provider to hold the bill
Ask a provider in writing to pause collection, interest and late fees on a bill while your insurance appeal is decided.
Letter or script
- Dispute a medical debt on your credit report
Ask a credit reporting company to investigate a medical account on your report that is wrong, unsettled or still under insurance appeal.
Letter or script
- Hospital financial assistance cover letter
A cover letter to send with your hospital's financial assistance application, asking for a hold on the bill and a written decision.
Letter or script
- Name someone to act for you
A plain written statement naming a family member, friend or advocate to speak and write to your health plan for you about a claim or appeal. It does not replace the plan's own form.
Letter or script
More letters and checklists 3
- Offer to settle a medical bill
Offer a single payment to settle a medical bill in full, and ask for the agreement in writing before you pay.
Letter or script
- Phone script: first call to the billing office about a surprise bill
What to say on your first call to a provider's billing office about a bill that may be a surprise bill: what to ask for, what to write down, how to ask for a hold in writing, and what to say if they mention collections.
Letter or script
- Tell the provider the No Surprises Act may apply to your bill
Write to the provider's billing office to say the federal No Surprises Act may apply, ask them to bill only your in-network share, hold the account while your plan reprocesses the claim, and confirm in writing.
Letter or script
Programs and services 28
Run by other organizations. We summarize them and say when we last checked.
- Program or service
1-800-MEDICARE: talk to a person about Medicare
The Medicare phone line and live chat, open all day every day. Staff can point you to the right step for a complaint, and can pass an unresolved complaint to the Medicare Beneficiary Ombudsman.
From Medicare (Centers for Medicare & Medicaid Services)
- Program or service
American Cancer Society 24-hour helpline
A phone and chat line staffed around the clock by cancer information specialists who answer questions and connect you to services. It is an information and referral line, not an appeals service.
From American Cancer Society
- Program or service
An Arm and a Leg: First Aid Kit
An archive of articles and starter packs from the podcast An Arm and a Leg, including a starter pack on what to do if you are in collections for medical debt. General reporting on health care costs, not appeal steps.
From An Arm and a Leg
- Program or service
Cancer Legal Resource Center and Cancer Justice helpline
A legal helpline and resource library for people with cancer, run by the Disability Rights Legal Center. Covers legal questions about insurance, work and money. Whether staff can take your case is not stated.
From Disability Rights Legal Center
- Program or service
Claimable
A paid service that builds an appeal for specific denied medicines and mails and faxes it for you. It lists about 85 medicines and does not cover other kinds of denial. Price is shown after you start.
From Claimable, Inc.
- Program or service
Community Health Advocates (New York)
New York State's designated consumer assistance program: a free helpline and local advocates for New Yorkers with any kind of coverage, plus do-it-yourself appeal guides. Open to New York residents only.
From Community Service Society of New York
- Program or service
Connecticut Office of the Healthcare Advocate
A free Connecticut state office that helps residents understand their benefits and speaks up for them when a claim or a prior authorization request (advance approval for care) is denied. Open to people with any kind of coverage.
From State of Connecticut, Office of the Healthcare Advocate
- Program or service
Consumer Assistance Programs: state health insurance help
A federal map of state Consumer Assistance Programs that help people with health insurance problems by phone, mail, email or in person, and what to try if your state has none.
From Centers for Medicare & Medicaid Services
- Program or service
Consumer Financial Protection Bureau: medical bills in collections and on credit reports
Federal consumer-bureau explanation of debt collection and credit reporting rules when a medical bill goes to collections, including surprise bills, with how to dispute and where to complain.
From Consumer Financial Protection Bureau
- Program or service
Consumer Financial Protection Bureau: what to do if you cannot pay a medical bill
Federal consumer-bureau guidance on checking whether you owe a bill, looking for billing errors, using appeal rights, financial assistance and payment plans, and avoiding collections.
From Consumer Financial Protection Bureau
- Program or service
Counterforce Health
A free artificial intelligence (AI) appeal letter generator for individuals, plus a large blog of drug, insurer and state guides. The tool sits behind an intake form and an email account.
From Counterforce Health, Inc.
- Program or service
Dollar For hospital financial assistance help
A free nonprofit service that helps you apply to a hospital for financial assistance (also called charity care) that can reduce or erase a hospital bill. It is about hospital bills, not insurance denials.
From Dollar For
- Program or service
Health Consumer Alliance (California)
A statewide partnership of legal aid organizations offering free help by phone or in person to Californians with Medi-Cal, Covered California or private coverage, including disputing denials and billing problems.
From Health Consumer Alliance
- Program or service
LawHelp.org free legal information and legal aid finder
A site that points you to free legal information and nonprofit legal aid providers in your state. It is a starting point for finding a program; it does not appeal a denial for you.
From LawHelp.org
- Program or service
Legal Services Corporation: find free legal aid
A search page that finds a civil legal aid organization near you. These organizations serve low-income people; the page does not say whether a local program takes health insurance cases.
From Legal Services Corporation
- Program or service
Legal Services Corporation: find legal aid near you
A search by address or city for civil legal aid organizations funded by the Legal Services Corporation, which supports free legal help for low-income Americans, with a link to LawHelp.org for information and forms.
From Legal Services Corporation
- Program or service
Maryland Attorney General: Health Education and Advocacy Unit
A free Maryland mediation service that helps with denied coverage from private health plans, plan terminations, surprise bills, hospital financial assistance and billing disputes.
From Office of the Attorney General of Maryland, Consumer Protection Division
- Program or service
Medical Bill Rights: find an action plan for your medical bill
A five-minute federal questionnaire about your billing problem that gives you suggested next steps, whether you already have a bill or are planning for care.
From Centers for Medicare & Medicaid Services
- Program or service
Medicare Rights Center national helpline
Free phone counseling for people with Medicare, their families and caregivers on benefits, denials and appeals, and cost-saving programs. Spanish is available. It covers Medicare only.
From Medicare Rights Center
- Program or service
National Alliance on Mental Illness HelpLine
A free, confidential helpline for mental health information, support and resources. It does not do individual advocacy or casework, so it will not fight a denial for you. In a crisis, call or text 988.
From National Alliance on Mental Illness
- Program or service
National Disability Rights Network: find your state agency
A directory of the federally mandated Protection and Advocacy agencies, one in every state and territory, that provide legal advocacy for people with disabilities, including difficulty getting disability services.
From National Disability Rights Network
- Program or service
National Organization for Rare Disorders patient assistance
Financial help for people with certain rare diseases with medicines, insurance premiums, co-pays, testing and travel, plus a patient services line. It is financial help, not an appeals service. Condition-specific.
From National Organization for Rare Disorders
- Program or service
Patient Advocate Foundation case management
Free one-on-one help from a case manager who can work on insurance denials and prior authorizations for patients with a serious or chronic condition who meet the program's rules. Intake is by phone and new cases are limited each day.
From Patient Advocate Foundation
- Program or service
Persius: denial support
An organization that says it helps people fight inappropriate coverage denials for free, using artificial intelligence (AI) with human review. It also does research on denials.
From Persius
- Program or service
Sheer Health
A paid membership service that connects to your insurance account, watches claims and, on paid tiers, handles denials and appeals for you, including calls to insurers. It does not teach you to appeal yourself.
From Sheer Health, Inc.
- Program or service
State Health Insurance Assistance Program locator (shiphelp.org)
The national site for finding your local State Health Insurance Assistance Program (SHIP), which gives free, one-on-one Medicare counseling, including help with complaints and appeals.
From SHIP National Technical Assistance Center
- Program or service
Triage Cancer legal and financial navigation
Free one-on-one phone help with health insurance, disability insurance, work and money questions from a cancer-focused legal-education nonprofit. It gives information, not legal representation or financial aid.
From Triage Cancer
- Program or service
Vermont Office of the Health Care Advocate (VTLawHelp)
A free helpline for Vermonters with health care and health insurance problems, run as a project of Vermont Legal Aid. Its website also has plain-language pages on appeals, grouped by the kind of coverage you have.
From Office of the Health Care Advocate, a project of Vermont Legal Aid
Your next step may connect
- Appeal
File the appeal, get a fast decision when health is at risk, and take it outside the plan if it says no again.
- Understand your denial
Work out what was refused, why, which rules apply to you, and by when you must act.