> At least in US you get the medical treatment first and then they hand you a large bill to pay.
A large bill which, if you're uninsured, you can almost always negotiate down to 10% or less of the original.
Of course, most people don't know this, but those large bills aren't what the hospitals expect uninsured patients to pay. They just legally have to present them the same initial bill that they present private insurers.
> How does one do this? Where do you learn it? Is there a book you suggest? The fact that I'm even asking this feel weird (I'm insured).
You can't do this if you're insured, because then the terms of your insurance apply. You can still get bills reduced, but the reasons are different and it's a bit more involved.
If you're uninsured, it's simple. You literally just tell them, "I have no insurance. I can't afford $45,000. It would take me years to pay that, and I'd probably default on the bill beforehand. However, if you reduce the billed amount to $500, I can pay that in full today, in cash.".
Substitute appropriate values in as needed, but that's the general idea. It's actually not all that different from what private insurers do, except they do all this up-front in bulk, so their rates are set in long-term contracts.
I don't disagree with the general message that these things are negotiable, but I'd love to see a citation showing real research on the effective rate. 10% seems way too low from my limited experience.
I've known people to successfully negotiate to 40-50% of original bill, usually with proof of (lack of) assets.
Maybe if you really are basically broke, they'll write you off rather than carry it on their books until they sell the debt. On the other hand if your bill is 45,000 and you have even meager assets : say a couple of cars and equity in a house, I'm guessing their going to try hard to see a good chunk of that.
There are businesses that are medical bill negotiators and charge you a percentage of the bill.
In general, they only negotiate hospital bills because they are the only bills large enough. I would say that the typical final negotiated rate they get from the hospital is about 3-20% of the billed amount. It depends on how high the original bill is, and it also depends on whether you need to make payments and how long the series of payments is.
Hospitals will certainly claim that you need to send in the proof of assets, usually you have to refuse about 6 or 7 times and they will relent.
However, things have changed in the last few years and professional medical bill negotiators have told me certain hospitals are completely unreasonable and refuse to negotiate. They advise these people to file bankruptcy.
You claim a 90% reduction is possible, then your example is a 99% reduction?
You're wrong either way. I've seen some bills my insurer pays around 2% of what is billed, but not most things. Hospitals will ofter sue, and they are aggressive about judgements. If you can pay something, they will take more.
Have you ever done this? Where did you hear this? Where have you seen it?
I have never had health insurance. Where I live many people don't have health insurance. I have never heard of this happening. I've seen peoples, my own included, wages garnished before this will happen. I currently have a $20k bill for an emergency appendectomy I had 4 weeks ago. The hospital will seriously take payments for 30 years before they'll lower any cost. If you want to negotiate, you'll have to wait until the collection agency has their account removed from your credit report 7 years after the first reporting. Any time before that you are in no position to negotiate with anybody.
EDIT: Unless your income is less than 1.5x the poverty level. In which case you qualify for aid in paying your bills.
Not the op, but I have done this on behalf of friends. Some with significant assets. Did you admit to having assets or significant income? If so, it might be very difficult to negotiate. Google for medical bill negotiation services or "lower my hospital bill" and you should be able to find some professionals near you. The consultation is always free. Be aware that some hospitals have become completely unreasonable in the last few years and would rather you file bankruptcy and collect nothing than negotiate. The initial consult with the negotiation service is always free and they will tell you if this is the case.
I think you make a good point, downvotes notwithstanding. A "market society" inherently rewards people who are good at "the game." Which is fine for most things: worst case scenario you pay too much for a shit car.
But having to play that damn game when you life is on the line is inhumane. There's no time out zone.
Yeah, it's wonderful how you can make it in such a system. Just imagine - a self-employed blue-collar worker slips with his car on a wet road. He loses his wife, his unborn child and his leg. He sells his house to pay the bills of the hospital and the mortician. His parents also pay some bills because he still had not enough. And then after a year or so on the street somebody tells him how negotiable these bills were. The American dream...
I hate negotiating for shit where my own identity is economically irrelevant. I suck at it, so if I go and buy a car I'm basically subsidizing people that are better at haggling.
That depends on if they are willing to negotiate with you before considering it a debt. If they send you to receivables with a 100k bill and you negotiate down to 10k cash, they are well within their rights to write off the 90k as debt forgiven. If they do so, you will be taxed on it.
Good luck finding a 90% off coupon for a surgery prior to the event.
A large bill which, if you're uninsured, you can almost always negotiate down to 10% or less of the original.
Of course, most people don't know this, but those large bills aren't what the hospitals expect uninsured patients to pay. They just legally have to present them the same initial bill that they present private insurers.