Practical first stepsMedical bills
Facing a Big Medical Bill? Charity Care, Itemized Bills and How to Negotiate
Jared Walker of the nonprofit Dollar For explains hospital financial assistance, how to ask for an itemized bill and negotiate it, and paying in installments, with a practice phone call.
Video by NPRPublished March 30, 2023Breakdown updated September 15, 2026
Key moments
“How to negotiate your medical bills | Life Kit” by NPR. We didn't make this video; it loads from YouTube when you press play.
What the video covers
A large medical bill often arrives marked due upon receipt, and many people assume they have to pay the full amount right away. Jared, founder of the nonprofit Dollar For, says the numbers can be negotiated and there's usually time to make a plan. He and host Marielle Segarra walk through charity care, itemized bills, negotiating and paying in installments.
The steps it walks through
- 1
Don't rush to pay; take time to make a plan.
- 2
Check whether you qualify for the hospital's charity care by searching its name plus "financial assistance," then apply with proof of income and follow up.
- 3
If you don't qualify, ask for an itemized bill and look up the procedure codes to confirm each service happened and the prices make sense.
- 4
Dispute errors in writing: ask the billing office for its email and mailing address, and ask for a supervisor if you're stuck.
- 5
If you can pay something now, ask what the settlement amount is without naming your number first, and call back on another day if the offer is too high.
- 6
If paying up front isn't possible, negotiate a monthly payment you can afford instead of putting the bill on a credit card.
What you can learn from it
Check financial assistance before paying
Jared's first step is to see whether you qualify for the hospital's charity care, often found by searching the hospital's name plus "financial assistance." Nonprofit hospitals must have a written financial assistance policy with eligibility criteria and an application process, but the income cutoffs differ from hospital to hospital.
Get an itemized bill and check it
Ask for an itemized bill and look up the procedure codes to confirm each service happened. Marielle got a $54 charge removed for a procedure she never had, and Jared suggests raising items that look overpriced too.
Put billing disputes in writing
In the role play, Jared doesn't argue with the first representative. He asks for the billing office's email and mailing address so he can send a written dispute, and he asks for a supervisor if someone won't budge.
Ask what the settlement amount is
If you can pay something now, Jared asks what the hospital will accept to close the account, without naming a figure first. He says Dollar For typically gets 30 to 50% off this way, sometimes after calling on different days; results vary.
Choose a payment plan over a card
If paying up front isn't possible, Jared says the monthly amount can be negotiated too. The CFPB suggests asking whether the provider will accept an interest-free repayment plan and warns that credit cards or medical credit cards may carry high interest.
Keep in mind
Jared's percentages reflect Dollar For's experience, not a rule. Financial assistance eligibility and protections differ by hospital and state, and the federal nonprofit-hospital requirements don't apply to for-profit hospitals, though many still have policies.
Common questions
Do nonprofit hospitals have to offer financial assistance?
Yes. Under section 501(r) of the tax code, nonprofit hospital organizations must have a written financial assistance policy covering emergency and other medically necessary care, spelling out eligibility criteria and how to apply.
Source: irs.govCan you negotiate a hospital bill?
Yes. The CFPB suggests asking for an itemized list of charges to catch errors, negotiating the bill down to an amount you can afford, and asking whether the provider will accept an interest-free repayment plan.
Source: consumerfinance.govHow long does a nonprofit hospital wait before taking collection action?
Under IRS 501(r)(6) rules, a nonprofit hospital must notify the patient about its financial assistance policy and generally hold off on extraordinary collection actions for at least 120 days after the first post-discharge bill. If a patient submits a complete application within the 240-day application period, the hospital has to decide whether they're eligible.
Source: irs.govSources
By DebtCheckUSAEditorial Team. This is our summary of a video we didn't make, and nobody paid us to include it. It's one person's experience, not financial, tax or legal advice. Advertiser disclosure
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