If you're struggling to pay your medical bills, you're not alone. Many people face this challenge, and there are programs available to help.
You can apply for Medicaid, a government-funded health insurance program that offers financial assistance to low-income individuals and families. In some states, Medicaid is also available to people with disabilities.
Some medical bills can be written off or reduced through medical debt forgiveness programs. For example, the National Foundation for Credit Counseling offers financial counseling and debt management plans that can help you negotiate with creditors.
Additionally, you may be eligible for financial assistance from your hospital or healthcare provider, such as charity care or sliding scale fees.
Medical Assistance Programs
If you're struggling to pay medical bills, there are several Medical Assistance programs available to help. You can file applications for these programs at your local health department, local department of social services, doctor's office, or hospital Social Work Department.
Maryland Children's Health Insurance Program (MCHP) provides full health benefits for children under 19 and pregnant women who meet income guidelines. The program covers children of employed parents whose employer doesn't offer family health insurance.
To apply for MCHP, you can complete an application online at https://www.marylandhealthconnection.gov/ or by telephone by calling the Maryland Health Benefits Exchange Consolidated Service Center at (855) 642-8572 or TTY (855) 642-8573.
Medicare Buy-In Program helps low-income Medicare beneficiaries pay out-of-pocket costs, including deductibles and co-payments. This program is also known as QMB and SLMB.
If you're eligible for Medicare but struggling to pay premiums, deductibles, and co-insurance, the Medicare Savings Program may be able to help. Coverage varies based on income, ranging from payment of all Medicare costs to paying only a portion of the Medicare Part B premium.
Here are some Medical Assistance programs you can explore:
- Maryland Children's Health Insurance Program (MCHP)
- Medicaid
- Medicare Buy-In Program (QMB and SLMB)
- Long Term Care Medical Assistance
You can also contact the Long Term Care/Waiver Medical Assistance (LTC) Application form hotline at 1-800-332-6347 or TTY 1-800-735-2258 for more information.
Understanding Medical Costs
Medicare Part D plans can have out-of-pocket costs ranging from $5.10 to $108.00 per month, depending on the plan chosen.
The annual deductible for Medicare Part D plans can be as high as $545, which is an annual amount that must be spent out of pocket before the insurer starts to fund treatments.
A person may need to pay a copay or coinsurance for prescription drugs, with some plans requiring a 25% copay or a flat amount until they reach a total cost of $13,172.18.
Here's a breakdown of the costs associated with Medicare Part D:
Keep in mind that these costs can vary depending on the plan and medications chosen.
Long Term Services Supports
If you're over 65 or have a physical disability, you may be eligible for Long Term Care Medical Assistance, which provides coverage for nursing home care if it's medically necessary.
Maryland offers several programs for long term care, including Nursing Facility (Long Term Care), Living Choices (Assisted Living), ARChoices, Community and Employment Supports, PACE, and Workers with Disabilities.
To qualify for these programs, you'll need to meet income, resource, and other criteria, which can vary depending on the program.
If you're in a nursing home, the care you receive must be medically necessary and you must meet the program's income and resource requirements.
For example, if you're 65 or older, you may qualify for Living Choices (Assisted Living) if you meet the income, resource, and other criteria, which will allow you to maintain your independence and dignity while receiving a high level of care and support.
Here are some specific programs and their eligibility requirements:
It's worth noting that some programs, like PACE and Workers with Disabilities, provide full coverage to eligible individuals, while others, like Living Choices, provide coverage in an assisted living facility.
Out-of-Pocket Costs
Out-of-Pocket Costs can be overwhelming, but understanding how they work can help you prepare.
Medicare Part D plans have their own formularies, which categorize drugs into different tiers based on cost. Drugs in lower tiers generally cost less than those in higher tiers.
Monthly premiums for Medicare Part D plans can range from $5.10 to $108.00. Annual deductibles can be as low as $0 or as high as $545.
Copays or coinsurance for Medicare Part D plans can be 25% or a flat amount, but only until you reach a total cost of $13,172.18. After that, catastrophic coverage kicks in, eliminating the need for copays or coinsurance.
Medicare Extra Help can significantly reduce out-of-pocket costs for those who qualify. In 2025, individuals who qualify pay $0 for their drug plan deductible, $0 for their Medicare drug plan premiums, $4.90 for each generic prescription, and $12.15 for each brand-name prescription.
Once your total drug costs reach $2,000, including payments made on your behalf, you'll pay $0 for each covered prescription.
Here's a breakdown of the costs associated with Medicare Part D plans:
Keep in mind that these costs can vary depending on the plan you choose and the medications you take.
How Much Do Ruse Rugs Cost?
Medicare Extra Help can significantly reduce prescription drug costs. The SSA estimates that it lowers costs by about $5,900 per year for each recipient.
People with Medicare Extra Help pay a $0 premium for Medicare Part D. They also don't have to meet a deductible.
In 2025, people pay a $4.90 copayment for generic drugs and a $12.15 copayment for brand-name drugs.
Frequently Asked Questions
How to get a medical bill reduced?
Negotiate directly with your healthcare provider to potentially lower your bill by explaining your situation. They may be willing to reduce the amount or set up a payment plan.
Sources
- https://dhs.maryland.gov/weathering-tough-times/medical-assistance/
- https://humanservices.arkansas.gov/divisions-shared-services/county-operations/health-care-programs/
- https://insurance.ohio.gov/wps/portal/gov/odi/consumers/medicare/medicare-part-d-extra-help-program
- https://www.medicalnewstoday.com/articles/what-is-medicare-extra-help-and-how-do-i-qualify
- https://www.eastidahonews.com/2024/03/how-to-get-extra-help-paying-for-prescriptions/
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