4 Ways to Save on Your Medical Bills

The number of Americans struggling to pay their medical bills is on the rise, and medical debt increasingly affects people at every income level, according to a new report from the Commonwealth Fund. The report, "Losing Ground: How the Loss of Adequate Health Insurance Is Burdening Working Families," paints a pretty bleak picture of how high healthcare costs are not only causing people to avoid getting the medical care they need but also straining their ability to pay for basic necessities like housing and food.

Letting the bills pile up unopened is a popular but ineffective way to address the problem. "They will come back to haunt you," says Mark Rukavina, executive director of the Access Project, a research and advocacy group that helps people tackle medical debt. There are much better strategies, says Rukavina, concrete steps you can take to reduce the amount you owe up front and manage any debt you've accumulated. Here's what he suggests:

Make your health plan pay its share. This sounds obvious, but too often people don't demand their due. When they get a notice saying their claim has been rejected, or that the insurer will cover only a portion of the cost, they simply pay up instead of questioning the charge. Don't do that. If you disagree with the insurer's determination, contest it first through the plan's internal appeals process. If you can't make headway there, contact your state health department or attorney general's office. They often have ombudsmen or other staffers who work with consumers on health insurance claim problems.

Check out government programs. If you qualify, enroll yourself or your children in public programs like Medicaid or the State Children's Health Insurance Program, or SCHIP. Eligibility standards vary by state, but several states cover children in families with income up to 300 percent of the poverty level, or more than $63,000 for a family of four. Added incentive: You may be able to get retroactive coverage though these programs for medical care received before you enrolled.

Negotiate with your providers. Don't be shy: Ask your doctor or hospital if you can get a discount and/or arrange a payment plan. You may be able to reduce your bill by as much as 40 percent or eliminate it entirely. Although many charity care and other assistance programs are income-based, providers also offer discounts to patients who have means but are facing hefty bills for expensive treatment.

Consider prompt payment discounts carefully . Some providers will shave as much as 30 percent off your bill if you pay at the time the service is provided. That's great if you have the money, but think twice before putting it on a credit card. Your savings may evaporate into interest charges.

The one thing you should never do: ignore the bills. When you or someone you love is sick, the last thing you want to think about is how you're going to pay for it all. But avoiding the problem won't make it go away. Need some help? The Access Project offers free assistance to help consumers deal with medical debt.