Medical bills can be crippling and debilitating debt. If you need help with medical bills, you’re not alone. An estimated 137 million Americans struggled with medical debt in 2019, and with COVID-19 resulting in job loss, that number is almost undoubtedly higher. Medical debt is also the root cause of 66.5% of bankruptcies. Medical bills can hinder your ability to do almost anything – saving for your child’s college tuition, buying a house, or even being able to put food on the table. It’s a weight that is on your shoulders that feels impossible to shake.

There is good news, though. No matter how impossible your medical debt may feel, you can take steps and strategies to reduce it. Here are some of the top things you need to know if you need help with medical bills.

Don’t Ignore Them

First and foremost, don’t ignore the medical bills. It can be tempting to do since you might figure that you have months to go before it goes to collections but ignoring them makes the problem much worse. When you ignore the bills, you risk a derogatory mark on your credit. You also risk losing the ability to negotiate or work with the hospital or doctor’s office on some sort of a payment plan (see one of the tips below for more details on this).

Even though you may feel drained emotionally by these bills and would prefer if they just went away, ignoring them is not an option. You do have to face this debt.

Ensure You Know All the Charges and That They’re Accurate

One of the most significant issues in tackling medical debt is that people often don’t know the full scope. Bills come in from Dr. A and Dr. B, hospital C, urgent care provider D, and lab E. It seems like every time you open your mail, someone wants you to come up with another thousand or two to pay them. Of course, not many people can come up with this type of money on-demand.

Therefore, when you receive medical bills, please put them in a spreadsheet and organize them in a meaningful way. Add all of them up, so you know the full scope of your debt.

If the hospital or provider isn’t sending you a breakdown of the charges, ask for one. Many times, there are billing errors (“hey, I didn’t get pain medication, why’s that on there?”), and this can reduce the amount of debt you have.

Once you have an accurate and clear picture of your medical debt, you can formulate a payment strategy.

Help with Medical Bills: Categorize Them Appropriately

Once you know the full scope of your debt, you’ll see that medical bills fall into one of three camps – those that you can pay, those that you could reduce over time, and those that you have no hope of ever repaying without help.

What to do with the bills that fall into the first bucket is obvious. If you have a $100 medical invoice, for example, and have $100 lying around, pay it and wipe out the balance.

Most bills, however, fall into the second camp. They’re bills that you could pay off, but you cannot pay right now. A $30,000 surgery bill falls into this bucket. Maybe if you could put $500 a month towards it, you could pay it off, but you don’t have $30,000 right now.

In that case, most hospitals and providers have an interest-free payment plan option. Call up the hospital and say that you can’t pay this as a lump sum, but you can pay over time. They’ll likely have a plan that they suggest by default. If that’s still too high of a monthly payment, tell the hospital what you can pay and go from there. Keep in mind that you do have a tremendous amount of negotiating power here. Many hospitals get nothing from many medical bills, so the fact that you’re willing to pay it off shows significant good faith.

For bills that you have no way of ever paying off (e.g. a $1,000,000 hospital stay bill), let the hospital know that. Most states and hospitals have financial aid available. For example, a hospital in California might be able to apply you for MediCal retroactively, thereby covering your bill for free. Again, though, let the hospital know your situation and explore options from there.

Do Not Put the Balance on Credit Cards, Apply for a Loan, or Pull From Your 401(k)

If you cannot afford your medical bills from savings, don’t put them on a credit card, get an egregious loan, or pull from your 401(k) to pay them unless you’ve thoroughly analyzed the situation and know it’s the best option. There are many reasons for this, but in terms of credit cards and loans, you’re effectively replacing one debt with another, and most hospitals have interest-free options anyway. So you’re taking on a loan with interest to pay one off that likely wouldn’t have interest.

As for 401(k)s, these retirement plans have shelter in bankruptcy. So, even if you do have to go bankrupt due to the medical bills, you’ll at least retain your 401(k). All too often, what happens is that people cash in their 401(k) to pay off bill A for $30k and then bill B comes at $100k. They wind up filing for bankruptcy anyway. Now they’re out their 401(k), plus they have the default on file.

Don’t cash in your 401(k)s or take on bad debt for help with medical bills. It’s almost always a bad idea.

Pay Cash Early for Help With Medical Bills

One other way to help with medical bills is to pay the bills you can afford with cash as early as possible. Many providers will offer discounts for prompt payments. That will free up some money to pay your more significant bills.

For example, you might have two bills, one that’s $1,000 and another for $10,000. You can pay the $1,000 quickly and secure a 10% discount. That frees up a little bit extra to put towards the $10,000 one and reduces your overall debt load a little.

You Can Pay Off Your Bills

Even though it may take time, you can pay down your medical debt. The key is not to ignore the bills and formulate a plan. Get a handle on all your debt and work with the providers as appropriate to pay it off. If you need help with medical bills, there’s also financial assistance that is typically available.