Are you overwhelmed by medical bills? You may be eligible for financial assistance from the hospital that provided you with treatment.

It is not clear if you will learn this information before your bills end up in debt collections.

Unexpected shocks such as medical bills can often cause financial problems. According to the non-profit Urban Institute, roughly 1 in 7 Americans with credit records have medical debts in collections.

Hospitals offer ways to prevent more people from joining their ranks. These include payment plans, income-based discounts, payment programs, help finding insurance, and waiving bills to be donated as charity care.

Patient counselors state that patients often miss out on notices about assistance in their bills or have difficulty filling out the paperwork required to qualify. According to them, hospitals should do more to inform patients about the available assistance.

Elisabeth Benjamin (Vice President, Nonprofit Community Service Society of New York) stated that “we need a whole different mindset.” “A hospital is a charity… (it should) be finding out why a patient can’t pay a bill.”

Affordable Care Act requires that nonprofit hospitals inform patients about financial assistance. However, it doesn’t specify how or what extent. The consistency of the information provided by patient counselors is not apparent.

According to hospitals, they notify patients often about the availability of help. They have also lowered income limits and simplified cumbersome applications during the COVID-19 pandemic.

It can be difficult to identify all who need help, Rick Gundling, senior vice president of the Healthcare Financial Management Association which consults with hospitals, stated.

Gundling stated, “I believe that many times, when a patient doesn’t possess the money, they retreat, or they don’t request help from the hospital, when it can help.”

It can be challenging to help people in times of medical emergency. Many patients don’t know what their care will cost or how much they will require. More confusion can be caused by a flurry of bills and insurance notices that arrive late.

Benjamin claimed that she helped one patient with a kidney stone removal and was paid 28 bills.

Hospitals often post notices regarding financial assistance on the emergency room walls or in bills that are sent to patients’ homes. These notices can be forgotten or overlooked.

“People don’t read the entire bill. They can be overwhelming and scary,” Benjamin said. He would love to see hospital bills include a single-page financial aid form.

Others advocate that financial assistance information should be printed on paper with a different color and better visibility. Hospitals should also be able to contact patients to determine if assistance is needed after a bill is past due.

According to Ilda Hernandez (a community health worker at Enlace Chicago), communication is often the greatest barrier that low-income patients face when dealing with hospitals.

Hernandez stated that most patients are not informed about the availability of assistance or whether hospitals have interpreters.

She said that patients are not informed they can request a social worker in a hospital.

Hernandez and Enlace helped a Spanish speaking janitor to resolve almost $100,000 in medical debt after his wife suffered two strokes last January.

Arturo, a Mexican immigrant of 43 years, spoke to The Associated Press under the condition that his last name not be published because he is afraid of being deported. Arturo said that he tried to talk about his bills with the hospital that had treated his wife. He never received any information about a possible solution to his debt until Enlace became involved.

He said, “When you get treated, it calms your down a bit… but once you have to pay the bills, where is the help?”

Information about hospital services is often posted online by hospitals. It can be difficult to find this information.

Jared Walker, a non-profit called Dollar For, which helps people with medical debt, published a TikTok video in January that shows how you can search for financial help on hospital websites. Since then, it has been viewed over 20 million times.

Walker stated, “Hospitals don’t shout from the rooftops that charity care can be applied for, that’s for damn certain.”

Some hospitals and state legislators are working to improve their facilities.

A couple of years ago, Oregon Health & Science University reduced its request for assistance.

The Portland academic health center asks for income from patients when they request help to pay for medically or emergency care. This is verified by a soft credit check. This approach replaces a paper application which required multiple documents.

“We are here to care for people. Kristi Cushman is the director of patient access services at the center.

According to the National Consumer Law Center, several states have laws that require hospitals offer discounted or free care. This is usually based on one’s income.

Maryland’s new law requires hospitals in Maryland to prove that they have provided financial information and made good faith efforts to establish a payment plan prior to suing over medical debt.

Marceline White, executive Director of the Maryland Consumer Rights Coalition, stated that this makes it appear the hospital has done everything it can to make patient payment affordable.

She said, “It shifts burden appropriately to hospital, multimillion-dollar entity as opposed to the individual making $40,000.”

Tennessee has not seen such burdens shift. Debra Smith is concerned that she might be denied future medical treatment because of her bills.

Spring Hill resident, who has Medicare coverage, estimates she has over $10,000 in unpaid medical bills resulting from a series of hospital stays she had over the past year. She hasn’t been able make much progress in paying them off.

Smith sought assistance from Williamson Medical Center in Franklin earlier this year to pay a $1500 bill. However, they were unable to agree on a payment plan that would work for her budget.

Smith is unable to work due to health problems. The $2,300 per month Smith receives from Social Security and a pension covers living expenses and prescriptions.

The application for financial assistance was available online by her, but she didn’t complete it. The form requests copies of bank statements, credit card bills, payments for cars, and utility bills. Smith felt that they wanted to give Smith reasons to reject her.

Mike Alday, a spokesperson for the medical center, said that he could not comment on any specific patient’s circumstances. However, he said that the medical center must confirm the patient’s financial needs before it can provide help. The information requested is the same for all hospitals.

Alday stated that the medical center offers financial counseling and discounts for patients who don’t submit financial aid applications. A person with $1,500 in outstanding debt would have 18 months to pay it off. This amounts to approximately $83 per month.

Smith estimates she can manage about $10 per month, which the hospital rejected.

“I am aware that hospitals need their money, but I don’t know how to help them.” She said that she was in the same situation. “I don’t want anything for nothing, but given the circumstances, a little understanding would help.”