Disclaimer
This article provides general information and is not legal or medical advice. For guidance specific to your situation, consult a qualified attorney or medical professional.
Detailed Answer
1. Understand Your Insurance Coverage
Review your summary of benefits to identify deductibles, copayments, coinsurance and out-of-pocket maximums. The Affordable Care Act caps in-network out-of-pocket costs. Knowing these figures helps you budget for care.
2. Request Good Faith Estimates
Maryland Code, Health-General § 19-309 requires hospitals to provide a written estimate for scheduled services upon request (HG § 19-309). Use these estimates to compare providers and plan expenses.
3. Explore Financial Assistance Programs
Maryland Medical Assistance (Medicaid) offers free or low-cost care for eligible individuals. You can also find subsidized plans through Maryland Health Connection: marylandhealthconnection.gov.
4. Use Community Health Centers
Federally Qualified Health Centers (FQHCs) charge sliding-scale fees based on income. Locate a center near you at findahealthcenter.hrsa.gov.
5. Document All Charges and Payments
After treatment, request an itemized bill and your Explanation of Benefits (EOB) from your insurer. Under Maryland Code, Health-General § 19-304, you have a right to inspect and copy medical records and billing information (HG § 19-304). Keep copies of all documents.
6. Negotiate Medical Bills
Contact the provider’s billing office to ask about discounts, payment plans or charity care. Many hospitals and practices offer financial assistance to patients who request it.
7. Appeal Insurance Denials
If your insurer denies a claim, follow its internal appeal process. If the outcome remains unfavorable, you can seek assistance from the Maryland Insurance Administration: insurance.maryland.gov.
Helpful Hints
- Ask for written estimates before scheduling non-emergency procedures.
- Track deadlines for appeals and assistance applications.
- Maintain a dedicated folder for all medical bills, EOBs and correspondence.
- Request medical records and billing documents well before any filing deadlines (typically within 30 days).
- Log all calls and emails with billing or insurance representatives, noting names and dates.