Negotiating with the government isn’t always easy, but they’re a great asset when it comes to medical bills. Government assistance for medical bills is one of the best uses for government assets and helps millions of Americans every year.
While federal financial assistance is available to almost everyone, it can be difficult to come by. It’s important to know which government programs you qualify for and how to apply for financial aid for medical bills. If you properly navigate the appropriate channels, government aid may save you from financial ruin.
- What is Government Assistance for Medical Bills?
- 6 Government Programs That Help pay Medical Bills
- 11 Non-Government Programs for Financial Assistance for Medical Bills (Non-Profit Organizations)
- Do All Hospitals Offer Their Own Financial Assistance Programs to Patients in Need?
- Frequently Asked Questions
- Can I Utilize the Government and Healthcare Advocates for Help with My Medical Bills?
What is Government Assistance for Medical Bills?
As the name implies, government assistance for medical bills is when you turn to government programs and agencies for financial assistance with medical debt. Government assistance with medical bills is available to all US citizens, illegal immigrants, and visitors in certain states. Government financial assistance can help pay for hospital bills and medical treatment, including tests, surgeries, procedures, appointments, etc.
Government programs to help pay medical bills are typically tax-funded. They’re specifically designed to help uninsured, underinsured, and low-income people, but they can help anyone who shows adequate need based on the household’s total income in relation to the federal poverty level. Most of the government assistance programs we know today are courtesy of the Affordable Care Act.
In addition to specific programs, the government also encourages individual hospitals to implement financial assistance policies. Currently, all non-profit hospitals and many for-profit hospitals implement these programs. Here’s how they work.
- Uninsured, underinsured, and low-income individuals receive free or discounted medical care from a hospital.
- The hospital documents the treatment and reports the amount of free care offered to the government.
- The government then offers the hospital tax credits and additional incentives in exchange for charitable care.
- If enough charitable care is offered, hospitals can retain their non-profit status.
Any hospital that offers financial assistance programs must have its guidelines readily available. Financial assistance policies, in addition to government assistance programs, account for the bulk of the charitable healthcare in the United States.
6 Government Programs That Help pay Medical Bills
Now that you know more about how government financial assistance for medical bills works, let’s look at some specific programs.
1. Medicare
Medicare is one of the most popular assistance programs in the country. Medicare is reserved for senior citizens over the age of 65 and younger people having disabilities.
What Does Medicare Cover?
There are three different forms of Medicare, each covering different bills.
Medicare Part A
Covers bills for stays at a skilled nursing facility, hospice, inpatient hospital visits, and home healthcare in certain situations.
Medicare Part B
Covers bills related to outpatient care, preventative care and services, certain doctor’s visits, and necessary medical supplies.
Medicare Part D
Covers bills pertaining to vaccinations, shots, and prescription drugs.
Who is Eligible for Medicare?
To be eligible for Medicare, you must be over the age of 65, have end-stage renal disease, or have another disability if you’re under the age of 65.
2. Extra Help
Closely associated with Medicare, Extra Help assists people with expensive prescription drugs if they only qualify for Medicare Part A or B.
Who is Eligible for Extra Help?
Anyone who qualifies for Medicare and has a low income qualifies for Extra Help.
3. Supplemental Security Income
The Supplement Security Income program was created by the Social Security program and is closely linked to it. While very similar to SSI, it isn’t employment-based, which means that more people qualify for it. Funds come courtesy of the US Treasury Fund and are given in addition to or apart from Medicaid and other benefits.
Who is Eligible for Supplemental Security Income?
To receive Supplemental Security Income, you must meet one of the following criteria.
- Blind
- Disabled
- Over 65
You also have to be a US citizen or legal resident residing in the country and be of low-income status.
4. Health Insurance Marketplace
As the name indicates, the Health Insurance Marketplace is a government website where you can browse health insurance plans. It caters to low-income people who are uninsured or underinsured and aims to give everyone a viable health insurance option. The Health Insurance Marketplace was established through the Affordable Care Act, and many of the available plans were as well.
Who is Eligible for the Health Insurance Marketplace?
Anyone who is a legal US resident living in the country can apply for health insurance through the Health Insurance Marketplace.
5. Medicaid
In addition to Medicare, Medicaid is one of the most popular government programs for low-income Americans. Currently, Medicaid is available to roughly 20% of US citizens and is the only healthcare option for some.
Who is Eligible for Medicaid?
While each state has some form of Medicaid, they can make their own eligibility requirements. Depending on where you live, eligibility will depend on your household income, size of household, income status, age, and disability.
6. Children’s Health Insurance Program
The Children’s Health Insurance Program (CHIP) is an extension of Medicaid specifically for minors. CHIP is also available to pregnant women in certain states. The goal of CHIP is to provide medical care and assistance to families who don’t qualify for Medicaid but also can’t afford private insurance.
Who is Eligible for CHIP?
As with Medicaid, every state has its own eligibility criteria for CHIP.
11 Non-Government Programs for Financial Assistance for Medical Bills (Non-Profit Organizations)
In addition to federal government programs, there are also a number of charities and non-profit organizations that can help you with medical bills.
1. HealthWell Foundation
The HealthWell Foundation strives to serve underinsured patients whose insurance isn’t doing enough. It can help with deductibles, premiums, pediatric treatment, prescription copays, and more.
Who is Eligible?
Anyone with health insurance but isn’t getting the help they need is eligible for the HealthWell Foundation.
2. Patient Access Network Foundation
As with HealthWell, the Patient Access Network Foundation (PAN) helps underinsured patients with their medical bills. PAN is specifically for those with life-threatening conditions, rare diseases, and chronic conditions. PAN can help with travel costs, copays, health insurance premiums, and more.
Who is Eligible?
If you fall within a certain percentage of the Federal Poverty Line, have health insurance that isn’t doing enough, and receive one of the qualifying medications, you are eligible for PAN. PAN stipulates that you must receive treatments in the US or a US territory, but you don’t have to be a US citizen.
3. Patient Advocate Foundation
The Patient Advocate Foundation (PAF) is one of the fastest-growing non-profit organizations in the country. They offer case management services to anyone suffering from a life-threatening, chronic, or otherwise debilitating disease or illness. Specifically, PAF funds help pay for health insurance copays and premiums, treatments, and financial grants.
Who is Eligible?
You must have a qualifying condition, be a US citizen, be a permanent resident, and receive treatments in the US or a US territory. You also qualify if you’re scheduled to receive treatment within 60 days of signing up.
4. Aunt Bertha
While Aunt Bertha doesn’t provide direct payouts, it’s an online database that helps individuals and organizations find the financial assistance they need. It’s a social care network that helps low-income patients find financial assistance programs related to food, medical fare, housing, and more.
Who is Eligible?
Anyone can use Aunt Bertha.
5. The Leukemia and Lymphoma Society
As the name indicates, The Leukemia and Lymphoma Society can help you pay medical bills related to certain types of cancer. The society helps with bills related to treatments, traveling for appointments, prescription drugs, co-pays, and more.
Who is Eligible?
Anyone with a qualifying disease and who falls within 600% of the US Federal Poverty Line is eligible for assistance from the Leukemia and Lymphoma Society.
6. The CancerCare Co-Payment Assistance Foundation
If you need help with co-payments related to cancer treatments, the CancerCare Co-Payment Assistance Foundation is for you.
Who is Eligible?
Anyone with a qualifying form of cancer and financial need is eligible for assistance.
7. Veterans of Foreign Wars
The Veterans of Foreign Wars (VFW) provides financial assistance to military families for all types of financial issues, including medical bills.
Who is Eligible?
Anyone who has served in the military.
8. Catastrophic Illness in Children Relief Funds
The Catastrophic Illness in Children Relief Fund helps with medical bills and financial needs for families with children that have serious illnesses or special needs.
Who is Eligible?
Each state has its own eligibility criteria.
9. The National Association of Free and Charitable Clinics
The National Association of Free and Charitable Clinics (NAFC) is a collection of healthcare facilities offering free or discounted care to patients. There are more than 1,400 such clinics throughout the country.
Who is Eligible?
Anyone can go to a free clinic, but their services should be reserved for uninsured, underinsured, and low-income patients.
10. NeedyMeds
NeedyMeds is a database and organization that helps you find affordable prescription drugs. NeedyMeds also helps you find free clinics, affordable healthcare, and other medical services.
Who is Eligible?
Anyone can use the NeedyMeds database.
11. Medical Billing Advocates
Medical billing advocates are healthcare pros who can help you understand your medical bills, negotiate them, and find potential errors. Medical billing advocates can save you thousands of dollars on your medical bills.
Who is Eligible?
Anyone can utilize the services of a medical billing advocate.
Do All Hospitals Offer Their Own Financial Assistance Programs to Patients in Need?
Only non-profit hospitals are required to offer financial assistance programs to patients in need. However, thanks to government incentives and state regulations, many of them do.
Here’s a list of states that require all of their hospitals to have financial assistance policies, regardless of non-profit status:
- Washington
- Rhode Island
- California
- Illinois
- Connecticut
- Maine
- Nevada
- Maryland
- New York
- New Jersey
It’s important to check the rules and regulations of your state as it relates to financial assistance. You should also ask your hospital if they have a financial assistance policy and compare that policy to state and federal regulations to make sure it’s compliant.
Frequently Asked Questions
Can I Utilize the Government and Healthcare Advocates for Help with My Medical Bills?
The best way to ensure you can pay your medical bills is to utilize the best of both worlds – government programs and medical billing advocates.
A healthcare advocate will help you know which government programs you qualify for and help you sign up for them. Healthcare advocates can also help you find non-profits, charities, and other organizations to assist you with your medical bills.
Contact us to schedule a consultation and to learn more about how a healthcare advocate can serve you.