Part of: Bills and help

A way to browse

You do not have to pay yet.
And you do not have to do this alone.

An appeal can take months, and the bill does not wait. This area covers what to do about the bill in the meantime, how to get it reduced whatever the appeal decides, and where to find a person who does this for a living.

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Tools for this step

4 tools

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16 guides

16 guides in this area

  • Guide

    Help with drug costs

    Two different problems get mixed up: your plan will not cover a drug, or you cannot afford your share. Fix the first with an exception or appeal, and look at nonprofit directories for the second.

  • Guide

    Medicare counseling through the State Health Insurance Assistance Program

    Every state has a free Medicare counseling program that is not tied to any insurance company. Here is what it does, how to reach it, and when to call 1-800-MEDICARE or a quality improvement organization instead.

  • Guide

    What a state consumer advocate does

    Some states run or fund free consumer advocates who explain your plan, write appeals and push back on insurers. Here is what three of them do, and how to find out what your state offers.

Letters, checklists and programs

37 items
  • The bill while you appeal

    How to keep a bill from getting worse while your appeal is pending, check what you actually owe, and look for ways to reduce it.

    Checklist

  • Ask a collector to validate a debt

    Ask a collection company in writing to prove what it says you owe, and to pause collection while you appeal and check the bill.

    Letter or script

  • Ask the provider to hold the bill

    Ask a provider in writing to pause collection, interest and late fees on a bill while your insurance appeal is decided.

    Letter or script

  • Dispute a medical debt on your credit report

    Ask a credit reporting company to investigate a medical account on your report that is wrong, unsettled or still under insurance appeal.

    Letter or script

  • Hospital financial assistance cover letter

    A cover letter to send with your hospital's financial assistance application, asking for a hold on the bill and a written decision.

    Letter or script

  • Name someone to act for you

    A plain written statement naming a family member, friend or advocate to speak and write to your health plan for you about a claim or appeal. It does not replace the plan's own form.

    Letter or script

More letters and checklists 3
Programs and services 28

Run by other organizations. We summarize them and say when we last checked.

  • Program or service

    1-800-MEDICARE: talk to a person about Medicare

    The Medicare phone line and live chat, open all day every day. Staff can point you to the right step for a complaint, and can pass an unresolved complaint to the Medicare Beneficiary Ombudsman.

    From Medicare (Centers for Medicare & Medicaid Services)

  • Program or service

    American Cancer Society 24-hour helpline

    A phone and chat line staffed around the clock by cancer information specialists who answer questions and connect you to services. It is an information and referral line, not an appeals service.

    From American Cancer Society

  • Program or service

    An Arm and a Leg: First Aid Kit

    An archive of articles and starter packs from the podcast An Arm and a Leg, including a starter pack on what to do if you are in collections for medical debt. General reporting on health care costs, not appeal steps.

    From An Arm and a Leg

  • Program or service

    Cancer Legal Resource Center and Cancer Justice helpline

    A legal helpline and resource library for people with cancer, run by the Disability Rights Legal Center. Covers legal questions about insurance, work and money. Whether staff can take your case is not stated.

    From Disability Rights Legal Center

  • Program or service

    Claimable

    A paid service that builds an appeal for specific denied medicines and mails and faxes it for you. It lists about 85 medicines and does not cover other kinds of denial. Price is shown after you start.

    From Claimable, Inc.

  • Program or service

    Community Health Advocates (New York)

    New York State's designated consumer assistance program: a free helpline and local advocates for New Yorkers with any kind of coverage, plus do-it-yourself appeal guides. Open to New York residents only.

    From Community Service Society of New York

  • Program or service

    Connecticut Office of the Healthcare Advocate

    A free Connecticut state office that helps residents understand their benefits and speaks up for them when a claim or a prior authorization request (advance approval for care) is denied. Open to people with any kind of coverage.

    From State of Connecticut, Office of the Healthcare Advocate

  • Program or service

    Consumer Assistance Programs: state health insurance help

    A federal map of state Consumer Assistance Programs that help people with health insurance problems by phone, mail, email or in person, and what to try if your state has none.

    From Centers for Medicare & Medicaid Services

  • Program or service

    Consumer Financial Protection Bureau: medical bills in collections and on credit reports

    Federal consumer-bureau explanation of debt collection and credit reporting rules when a medical bill goes to collections, including surprise bills, with how to dispute and where to complain.

    From Consumer Financial Protection Bureau

  • Program or service

    Consumer Financial Protection Bureau: what to do if you cannot pay a medical bill

    Federal consumer-bureau guidance on checking whether you owe a bill, looking for billing errors, using appeal rights, financial assistance and payment plans, and avoiding collections.

    From Consumer Financial Protection Bureau

  • Program or service

    Counterforce Health

    A free artificial intelligence (AI) appeal letter generator for individuals, plus a large blog of drug, insurer and state guides. The tool sits behind an intake form and an email account.

    From Counterforce Health, Inc.

  • Program or service

    Dollar For hospital financial assistance help

    A free nonprofit service that helps you apply to a hospital for financial assistance (also called charity care) that can reduce or erase a hospital bill. It is about hospital bills, not insurance denials.

    From Dollar For

  • Program or service

    Health Consumer Alliance (California)

    A statewide partnership of legal aid organizations offering free help by phone or in person to Californians with Medi-Cal, Covered California or private coverage, including disputing denials and billing problems.

    From Health Consumer Alliance

  • Program or service

    LawHelp.org free legal information and legal aid finder

    A site that points you to free legal information and nonprofit legal aid providers in your state. It is a starting point for finding a program; it does not appeal a denial for you.

    From LawHelp.org

  • Program or service

    Legal Services Corporation: find free legal aid

    A search page that finds a civil legal aid organization near you. These organizations serve low-income people; the page does not say whether a local program takes health insurance cases.

    From Legal Services Corporation

  • Program or service

    Legal Services Corporation: find legal aid near you

    A search by address or city for civil legal aid organizations funded by the Legal Services Corporation, which supports free legal help for low-income Americans, with a link to LawHelp.org for information and forms.

    From Legal Services Corporation

  • Program or service

    Maryland Attorney General: Health Education and Advocacy Unit

    A free Maryland mediation service that helps with denied coverage from private health plans, plan terminations, surprise bills, hospital financial assistance and billing disputes.

    From Office of the Attorney General of Maryland, Consumer Protection Division

  • Program or service

    Medical Bill Rights: find an action plan for your medical bill

    A five-minute federal questionnaire about your billing problem that gives you suggested next steps, whether you already have a bill or are planning for care.

    From Centers for Medicare & Medicaid Services

  • Program or service

    Medicare Rights Center national helpline

    Free phone counseling for people with Medicare, their families and caregivers on benefits, denials and appeals, and cost-saving programs. Spanish is available. It covers Medicare only.

    From Medicare Rights Center

  • Program or service

    National Alliance on Mental Illness HelpLine

    A free, confidential helpline for mental health information, support and resources. It does not do individual advocacy or casework, so it will not fight a denial for you. In a crisis, call or text 988.

    From National Alliance on Mental Illness

  • Program or service

    National Disability Rights Network: find your state agency

    A directory of the federally mandated Protection and Advocacy agencies, one in every state and territory, that provide legal advocacy for people with disabilities, including difficulty getting disability services.

    From National Disability Rights Network

  • Program or service

    National Organization for Rare Disorders patient assistance

    Financial help for people with certain rare diseases with medicines, insurance premiums, co-pays, testing and travel, plus a patient services line. It is financial help, not an appeals service. Condition-specific.

    From National Organization for Rare Disorders

  • Program or service

    Patient Advocate Foundation case management

    Free one-on-one help from a case manager who can work on insurance denials and prior authorizations for patients with a serious or chronic condition who meet the program's rules. Intake is by phone and new cases are limited each day.

    From Patient Advocate Foundation

  • Program or service

    Persius: denial support

    An organization that says it helps people fight inappropriate coverage denials for free, using artificial intelligence (AI) with human review. It also does research on denials.

    From Persius

  • Program or service

    Sheer Health

    A paid membership service that connects to your insurance account, watches claims and, on paid tiers, handles denials and appeals for you, including calls to insurers. It does not teach you to appeal yourself.

    From Sheer Health, Inc.

  • Program or service

    State Health Insurance Assistance Program locator (shiphelp.org)

    The national site for finding your local State Health Insurance Assistance Program (SHIP), which gives free, one-on-one Medicare counseling, including help with complaints and appeals.

    From SHIP National Technical Assistance Center

  • Program or service

    Triage Cancer legal and financial navigation

    Free one-on-one phone help with health insurance, disability insurance, work and money questions from a cancer-focused legal-education nonprofit. It gives information, not legal representation or financial aid.

    From Triage Cancer

  • Program or service

    Vermont Office of the Health Care Advocate (VTLawHelp)

    A free helpline for Vermonters with health care and health insurance problems, run as a project of Vermont Legal Aid. Its website also has plain-language pages on appeals, grouped by the kind of coverage you have.

    From Office of the Health Care Advocate, a project of Vermont Legal Aid

Your next step may connect

  • Appeal

    File the appeal, get a fast decision when health is at risk, and take it outside the plan if it says no again.

  • Understand your denial

    Work out what was refused, why, which rules apply to you, and by when you must act.