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Reducing Your Medical Debt


Kairol Rosenthal was diagnosed with cancer at 27 and discovered two days later she had been dropped by her insurance. Since then, she has spent the last decade fighting for her own health insurance, advocating for other young adult cancer patients, and researching and writing Everything Changes: The Insider’s Guide to Cancer in Your 20s and 30s. She’s here today to share with us tips on how to reduce your doctor bills. Take it away, Kairol:

The first step to reducing your medical debt is asking your doc or hospital upfront for a discount on your bill. Below are some great pointers I’ve adapted from the National Endowment for Financial Education’s brochure Avoiding and Managing Medical Debt. These steps take time, chutzpah, and smarts but the dough you’ll save is well worth the work. (Plus, I try to have fun with it by pretending I’m an underdog powerhouse like Erin Brockovich.)

1. Go into this with a good attitude. Your odds are good: 50% of people who ask for reduced costs get them, plus your chances might be higher using these savvy strategies.

2. Talk to the right person, face-to-face: Your doc, your doc’s or hospital’s office, business, or billing manager. Don’t do it by phone or letter.

3. Honey goes farther than vinegar. Don’t whine, bitch or complain. Be polite. Kill’em with kindness.

4. Be persistent. Don’t take no for an answer. (I never do!) Many hospital staff don’t know the correct policies and will say “no” when they should say yes. Work your way up the ladder asking politely to talk to supervisors and don’t stop till you get to the top or until you get a yes.

5. Use organized ammo. Build your argument by finding a copy of the hospital’s free and discounted care policy. Search for it online or ask for a copy from the hospital. You might find info about it in their mission statement.

Or…The American Hospital Association has a Billing and Collections Practices Policy. 4,200 hospitals have signed on agreeing to assist patients who cannot pay for all or part of their care and make these policies accessible and written in clear language. Visit this link and click on “more than 4,200” and see if your hospital is on the list. If so, you’ve got some ammo. Use it.

6. Contact your State Attorney General. If you are at a non-profit hospital, many state AG’s will help ensure your hospital provides charity care. Find your State AG here. This call might be a red tape chore, but again, it could help save you big bucks.

7. Compare costs. People who have insurance usually pay less money for the same procedure than people who do not have insurance. Crazy and unfair, I know. But use it to your advantage. If you do not have insurance, do some high-level sleuthing to find out what patients with insurance or Medicare are paying for your same procedure codes and demand that you are charged the same.

8. Get it in writing. If a doctor or hospital agrees to your request, get it in writing!

For more financial assistance resources and money saving tips, download the first chapter of Everything Changes: The Insider’s Guide to Cancer in Your 20s and 30s, called Ramenomics.


  1. feistysurvivor

    This is an awesome article Kairol!I have a question that no one seems to be able to answer. I left a job in July, and didn't get health insurance through my new employer until 9/1. I am curious if I should pay the cobra even though I didn't need insurance during the time–just to make sure I don't fall into the lapse in coverage pre-existing condition category? Does anyone have any clues? I don't want to drop 1,200 bucks if I don't have to!! THANKS!!

  2. Kairol Rosenthal
    Kairol Rosenthal09-21-2010

    Hi Feistysurvivor -

    To clarify, I assume you are asking if you should pay retro-actively for the months this summer that you would have been using cobra.

    This is a great question because it brings up the ever important issue of “gaps in coverage”. I put this in quotes because gaps in coverage are actually technical loop holes that insurance companies can use to deny you coverage for conditions that occur during this gap. The impact of this can depend on the exact number of days for which you were not covered, as well as other factors.

    These loop holes are based on laws, so always, always seek advice from a lawyer. Even if you have a great social worker, or seemingly savvy bloggers or patients giving you pointers, still ask a lawyer.

    Don't worry, there are great pro-bono lawyers who can help answer these questions for you and it won't cost a dime. I used lots of pro-bono legal assistance over the past ten years to help me navigate insurance questions.

    Call the Cancer Legal Resource Center. Briefly explain your question and ask for them to have someone call you back with an answer. Their phone number is 866-THE-CLRC. The people who answer the phones are often legal interns. Sometimes they can be slightly out of the loop or frustrating to deal with. Don't worry, they are simply taking your message, they are not the ones who are counseling you on what to do. If you don't get a call back in two days, keep calling and reminding them you need a call back. They are a fantastic organization that fields thousands of calls, so be kind and patient with them.

    If you have any other questions, feel free to contact me. My email address is on my blog.

    Best of luck to you in your new job.


  3. Melanie Clay
    Melanie Clay09-26-2010

    I loved this posting. I actually have the book ( bought it over two years ago) and was pleased that you spoke on behalf of the SAMFund! This book really helped me with a lot of the issues after cancer therapy…so thank you Kairol.


  4. Kairol Rosenthal
    Kairol Rosenthal09-29-2010

    Hi Melanie,

    So glad that Everything Changes has helped you. Thanks for your comment and hope you are doing well.


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