Climbing Out from Under Medical Debt

It's no secret that the cost of medical care has spun out of control. A studypublished in The American Journal of Medicine last year found that in 2007, 62% of all bankruptcies in this country were related to medical expenses. What's more, three quarters of people with medical debt had health insurance.

That survey was conducted before the economic meltdown that began in 2008. We must assume, therefore, that those numbers are even higher today.

If you're among the millions of Americans struggling with medical debt, here are some steps you can take to help yourself.

• Say "No" to medical credit cards. Medical debt is interest-free and doesn't usually show up on a credit report unless it goes to collection. Once you pay for your medical expenses on a credit card, you close out your account with your medical provider and turn it into consumer debt, which does appear on your credit report and is subject to high interest rates. You also shut down any chance of negotiating with the hospital or doctor.


• Review your bills. As I covered in last week's post, a huge number of medical bills contain inaccuracies. Make sure you look for duplicate or inappropriate charges before you pay any bills.


• Did your insurer pay? Confirm that your health care provider has properly billed your insurer and that your insurer has, in turn, paid what it owes.


• Appeal care denials. If your care was denied, check into your insurance company's appeals process. Under the new health reform law, health plans created after March 23, 2010 must allow you to appeal denials. If the internal appeal is denied, your plan is required by law to explain why and provide you with information about how to obtain an independent review of your case.


• Negotiate. Always ask for a better price on your medical care.


• Ask for a payment plan. Ask to pay off your debt over time and request that the hospital or doctor not report your bill to a debt collector while you do. Do your best to negotiate a plan that's interest-free, and don't agree to a plan that requires you to pay the bill in full if you miss a payment.

What if You Can't Pay?

If you're unable to pay your medical bills, here are a few options to consider:

• Explore Medicaid. Many states will take high medical bills into account when evaluating eligibility for Medicaid coverage. Even if you weren't previously eligible, medical debt may change your status.


• Ask for financial assistance. Many hospitals and clinics offer free or low-cost care to help people otherwise unable to pay. Talk with your provider's billing office and ask if it will either forgive some of your debt or offer treatment at a lower-cost. To find a hospital or health center in your area that provides free or low-cost care, go to the U.S. Department of Health and Human Services resource web site .

For help dealing with medical debt, search for consumer assistance programs by state at the nonprofit Families USA. For free legal assistance, check lawhelp.org. You can also work with a certified credit counselor.

Got a health insurance question? Post it below. I'll respond in this blog each Thursday to as many of your questions as I can.

The opinions expressed in the WebMD Blogs are of the author and the author alone. They do not reflect the opinions of WebMD and they have not been reviewed by a WebMD physician or any member of the WebMD editorial staff for accuracy, balance or objectivity. WebMD Blogs are not a substitute for professional medical advice, diagnosis, or treatment. Never delay or disregard seeking professional medical advice from your physician or other qualified health provider because of something you have read on WebMD. WebMD does not endorse any specific product, service or treatment. If you think you have a medical emergency, call your doctor or dial 911 immediately.

Routine Chest X-Rays May Not Cut Lung Cancer Deaths

Oct. 26, 2012 (Honolulu) -- Getting a routine chest X-ray is not likely to reduce your chance of dying from lung cancer.

That's the result of a study published in The Journal of the American Medical Association and presented at the annual meeting of the American College of Chest Physicians.

It came as a disappointment because more people die of lung cancer worldwide than any other cancer. Researchers are looking for ways to detect lung cancer before it grows too difficult to treat effectively.

"We were hopeful the chest X-rays we did would make a difference," study researcher Paul A. Kvale, MD, tells WebMD.

Still, another expert stresses that patients should not assume chest X-rays are useless. They are still helpful in cases where doctors already have some reason to believe the patient has cancer.

"We should not confuse the value of the chest X-ray in someone who has symptoms of lung cancer with the value of the chest X-ray in someone who does not have symptoms," says Frank C. Detterbeck, MD. Detterbeck is a Yale University lung cancer specialist. He was not involved in the new study.

Drugs That Control Genes May Treat Lung Cancer

Nov. 9, 2011­ -- A new approach to treating cancer appears to help certain patients with advanced lung cancer, and researchers say they think they may have a way of spotting those who will benefit.

The small study is generating big excitement in the world of cancer treatment because it demonstrates that so-called epigenetic drugs may work when traditional chemotherapy has failed.

Epigenetic drugs work by controlling gene expression -- the way information from genes is used to create products such as proteins.

The study is published in Cancer Discovery.

"This is a ... groundbreaking study, showing that by modifying the epigenetics of a cancer cell we can get real responses in lung cancer," said Jeffrey A. Engleman, MD, PhD, director of thoracic oncology at Massachusetts General Hospital, in Boston, in a news briefing. "And getting real responses in lung cancer is actually quite difficult, so we take special notice of therapies that can do this." He was not involved in the research.

Gene Test May Help Determine Early Lung Cancer Survival

Jan. 26, 2012 -- A new test that measures the activity of certain genes in cancer cells may help doctors tell which early, non-small-cell lung cancers are the most dangerous.

The hope is that doctors can use that information to figure out which patients might benefit from more aggressive treatment for their early lung cancers.

Lung cancer is one of the most common cancer types. It’s also one of the deadliest, even for the lucky few who catch their tumors while they are still small and have not spread.

Unlike stage I breast cancer, which has a five-year survival rate of 88%, stage I non-small-cell lung cancer has a five-year survival rate of 45% to 49%, according to the American Cancer Society.

There are some effective therapies for people with stage I lung cancer that are not always used because it is difficult to identify the best patients for those therapies, Michael J. Mann, MD, a thoracic surgeon and associate professor of surgery at the University of California, San Francisco, tells WebMD. 

“Just matching patients to an effective therapy in a slightly more efficient manner would actually improve the survival rate for lung cancer, which is an accomplishment that has eluded medical scientists for three decades,” he says.