Patricia Kelmar
Senior Director, Health Care Campaigns, U.S. PIRG Education Fund
[email protected]
Consumer Protection Week 2025: How to lower your medical bills
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Mark Morgenstein
Director of Media Relations, The Public Interest Network
[email protected]
Know your rights when it comes to protesting bills, appealing claim denials
WASHINGTON – Many families plan for expected expenses, but medical bills can throw off even the most carefully crafted budget. When people know their rights and protections, they can better fight erroneous medical bills, appeal insurance company denials of coverage and budget better by finding out prices in advance.
According to a national study, annual out-of-pocket spending for health care averaged $1,425 per person in 2022. That lofty sum means it’s more important than ever for people to know and understand their rights when it comes to medical bills.
“Some folks feel they can’t do anything about large medical bills and just hope they never need to use the health system,” said Patricia Kelmar, U.S. PIRG Education Fund’s health care campaigns director. “But every person should know and use the rights they have to lower their medical bills. Health care might still cost a lot, but no one should ever pay a bill their insurance should have covered. And everyone should fight bills they simply don’t owe.”
U.S. PIRG Education Fund is celebrating National Consumer Protection Week 2025 by promoting these important billing protections every family should know and use:
1. When scheduling care, find out prices in advance. For people with insurance, use in-network doctors and hospitals and ask your insurer how much you will be expected to pay. Ask your insurer if you need “pre-authorization” before getting the care. For people who don’t have insurance or won’t be using it for their care, ask the medical care provider for a written Good Faith Estimate. The provider can’t charge you more than $400 above that estimate.Use U.S. PIRG Education Fund’s tips: How to get a good faith estimate for medical and dental care
2. If your insurance company denies your claim, appeal it. Less than 1% of people appeal their insurance claim, but studies show that people who do win about 75% of the time. Use U.S. PIRG Education Fund’s tips: Did your insurance deny your health care claim? How to appeal.
3. When you get your bill, scrutinize it. Ask for an itemized bill and question any items you don’t understand. Alert your insurer and the health care provider to any mistaken billing and ask for a corrected bill. Use U.S. PIRG Education Fund’s tips: I received a medical bill I cannot afford to pay
4. Negotiate for a lower price. If you can’t afford your medical bill, call the provider and tell them what you can pay. Work with them to develop a low- or no-interest payment plan. Look up prices listed on hospital websites to see if other hospitals charge less and cite those prices to help you make a case. Use U.S. PIRG Education Fund’s tips. How to find hospital prices
5. Every year, check your credit report at no charge to be sure it doesn’t include any medical bills you don’t recognize or owe, or medical bills that are less than $500. Providers and hospitals make mistakes when sending bills. And paid-off medical debt should not appear. Don’t let incorrect bills ruin your credit history. Use U.S. PIRG Education Fund’s tips: How to make sure your credit reports don’t include paid medical debt
For other tips on fighting medical bills, check out our six-part guide: Medical Bills: Everything you need to know about your rights.