Getting Help with Medical Debt in Washington State

Authored By: Northwest Justice Project LSC Funded
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Having medical bills can cause fear, worry and embarrassment. You may start to lose hope. But ignoring them can lead to bigger problems. Your bills might be turned over to a collection agency. You might even get sued. If you cannot afford your medical debt, this publication explains some options that can help.


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Everyone has medical bills.  You may have Medicaid, Medicare, private health insurance, or a combination, but still have a large deductible or co-pay.  You may have no medical coverage at all. Having medical bills, especially when you have been sick, can cause worry, and additional stress. But ignoring these bills can lead to bigger problems. Your bills might be turned over to a collection agency or you might be sued.

If you cannot afford your medical debt, this publication explains some options that can help.

What is "medical debt?"

It is any money you owe for health care. You might owe a doctor or hospital, or a collection agency if a doctor or hospital turned the bill over to it.

Do not ignore any bill. Read it carefully. Make sure you know:

  • what the bill is for

  • what it says you owe

  • any mistakes on it

  • what each charge is for

  • what your insurance paid (if you have Medicaid, Medicare, or private medical insurance)

The charges can be confusing. If you have any questions, contact whoever sent you the bill.

*Do not assume your insurer has paid a bill.  You must follow up with the hospital, doctor, your insurance company, or DSHS to make sure the bill has been paid.  If it was not paid, find out why.  You may need to file an appeal with the provider or insurance company if payment has been denied.  If you are not sure of your rights, consult an attorney.

Even if your insurance paid some of the debt, you may not be able to afford to pay what the bill says you still owe. Below are some options that might help you pay the rest.

What is Medicaid?

It is a government-funded program that provides medical coverage for low-income individuals and families. If you cannot afford your hospital or other medical bills, ask the hospital or DSHS about helping you apply for Medicaid.

What is Charity Care?

Charity Care is a special program to help pay for hospital bills. Washington state law requires hospitals to give free or reduced-cost medical care to people who meet certain income qualifications. If you are getting health care in a hospital, or you have a bill for care you got at a hospital, ask for a Charity Care application to find out if you are eligible.

When the hospital admits you, it should provide notice of its Charity Care program.  You can ask for an application while in the hospital or after you are discharged.  You should apply as soon as possible after receiving hospital services.  However, you can apply for Charity Care at any time, even after your bill has been turned over to a collection agency or you have been sued for the debt.

Fill out the application and turn it in by the deadline stated on it. You will have to prove your income is low enough to get Charity Care. You will have to turn in proof, such as copies of:

  • pay stubs

  • income tax returns

  • forms from Medicaid

To make sure the hospital reviews your application and documents in a timely manner, you want to:

  • Make a copy of your documents and application before sending them in.

  • Get proof of delivery (fax confirmation or tracking with delivery confirmation).

  • If you hand in the application and documents at the hospital, ask the hospital employee who accepts your documents to sign and date your copy.

  • Follow up with a phone call to make sure the hospital has all the documents it needs to make a decision on your Charity Care application.

Our publication called  Can I Get Charity Care Benefits To Pay For My Hospital Bill  has more information. Get it at WashingtonLawHelp.org.

Charity Care covers hospital care only. It does not cover bills from doctors or others who treat you but who do not work for a hospital. No matter who is billing you -- for any service at a hospital, clinic, or doctor's office -- you can ask if financial assistance is available and how you can apply.  

People with insurance sometimes get charged less for health care than others who do not have insurance. If you do not have insurance, ask the hospital or doctor to charge you the same rate they charge insured patients, or some other amount that is a fair price for the service. Look on www.HealthCareBlueBook.com to find out a fair price for the health care you received.

Insurance or Charity Care paid some. I still owe medical bills. Should I pay with my credit card?

No! There are other options. Do not pay your medical bills with your credit card before exploring those other options. If you trade medical debt for credit card debt with interest, you will probably owe more than you need to and fall behind on your payments.

Talk to a financial counselor first.  For these and other bills Charity Care does not cover (or if you cannot get Charity Care), you can ask the hospital or doctor to agree to a payment plan.

First, figure out what kind of monthly payment you can afford. One of these non-profit Financial Counseling organizations can help you figure out the best way to handle your debt:

After you figure out what payment might be best for you, call the doctor or medical billing department. Explain your financial situation and offer a proposed payment plan.

Medical billing departments know you might have trouble paying your bills. If they already sent your bill to a collection agency, the hospital or doctor might be willing to take your account out of collections. If they agree on a payment plan, get a copy in writing of the new plan. Keep up with the lowered payments.

I am afraid of being sued over the medical debt. What can I do?

Act fast.
If your bill has been turned over to collections, talk to a financial counselor before making more payments.

If you are served with a lawsuit, you may have a defense if Charity Care, DSHS, or your insurance should have paid for some of your hospital or medical bills but did not. Our How Do I Answer a Lawsuit for Debt Collection publication has more information. Our interactive interview can help you create an answer to the lawsuit.

If you need more information about this or other legal issues, visit WashingtonLawHelp.org.

What if I need legal help?

CLEAR is Washington's toll-free, centralized intake, advice and referral service for low-income people seeking free legal assistance with civil legal problems. 

  • Outside King County: Call 1-888-201-1014 weekdays from 9:15 a.m. until 12:15 p.m. 

  • King County: Call 211 for information and referral to an appropriate legal services provider Monday through Friday from 8:00 am – 6:00 pm. You may also call (206) 461-3200, or the toll-free number, 1-877-211-WASH (9274). You can also get information on legal service providers in King County through 211's website at www.resourcehouse.com/win211/.

  • Persons 60 and Over: Persons 60 or over may call CLEAR*Sr at 1-888-387-7111, regardless of income.

Deaf, hard of hearing or speech impaired callers can call CLEAR or 211 using the relay service of their choice.
211 and CLEAR will conference in interpreters when needed at no cost to callers. 

Free legal education publications, videos and self-help packets covering many legal issues are available at www.washingtonlawhelp.org.



This publication provides general information concerning your rights and responsibilities. It is not intended as a substitute for specific legal advice.
This information is current as of July 2016.

© 2016 Northwest Justice Project — 1-888-201-1014.

(Permission for copying and distribution granted to the Alliance for Equal Justice and to individuals for non-commercial purposes only.)



Last Review and Update: Jul 11, 2016