Health is the first wealth - but it shouldn't cost you all of yours
This post is a little out of the ordinary, but we live in extraordinary times: the strike's been going on for over a hundred days, out-of-work script coordinators are arranging their own pet food drives for other support staff, and SCs and WAs are losing their MPI health insurance.
Even with insurance, it's not uncommon for a surprisingly large bill to hit your mailbox unexpectedly. For SCs and WAs, who are paid less than 20% of what our striking writer "kin" (I grind one of my fillings to dust every time I read that) are, money's already in short supply, and that bill may send a hard-working staffer into financial ruin. So while we generally like to keep things light here at ScriptCoord.com, we felt it was important to take some time to address one of the day-to-day issues our community is dealing with. In this case, it's that caught-in-your-throat how-the-hell-am-I-going-to-pay-this-bill moment. We're trademarking that, by the way. Get ready to put your bureaucracy-busting, battle-tested research ability and conversational combat arts to the test. But one quick note: Nothing in this post constitutes legal or financial advice.
Capice? Let's dive in.
1. If You Earned Under $60k, Find Out Your Hospital's Financial Assistance Options
Nonprofit Hospitals (like UCLA) are required to provide reduced-cost or free care (often called "charity care" - but don't let the name dissuade you) to financially-qualifying individuals. According to UCLA Health's Financial Assistance Page, you can receive a discount under the following conditions:
For Hospital Services
100% discount if family income is under 400% Federal Poverty Level ($58,320)
Partial discount if family income is within 401-450% Federal Poverty Level ($58,465-$65,610)
For Physician Services
100% discount if family income is under 200% Federal Poverty Level ($29,160)
Partial discount if family income is within 201-350% Federal Poverty Level ($29,305-$51,030).
The Federal Poverty Level for 2023 is $14,580 (for a family of 1) and it's not unlikely that you earned under $58k last year: at the 2022 scale rate of $24.50/hr, and assuming you worked a 60-hour-week, earning $1,715, you would have needed 34 weeks of work to have earned too much. That means with a little bit of paperwork, you can have an unexpected hospital bill completely covered by the hospital's own financial assistance programs. Physicians have a lower threshold, so while you may not qualify for a 100% discount, you can still get a couple lattes' worth skimmed off the top. Kaiser's Program, called the Medical Financial Assistance (MFA) Program, has lower threshsholds:
100% discount if family income is under 200% Federal Poverty Level ($29,160)
50% discount if family income is within 201-400% Federal Poverty Level ($29,630-$58,320)
For-Profit Hospitals may have their own programs, but are not required by law (like non-profits) to provide assistance.
2. Request and Review the Itemized Bill
If you were ever an office PA or had to pick up lunch for the writers' room, you know the importance of itemized receipts. The studio wants to know exactly what it cost and what it got for each of the hard-earned dollars it parted with.
So do you.
Call the billing office of the doctor, clinic, or hospital (it should be included on the bill or Explanation of Benefits you also received) and request an itemized bill. Like your lunch receipt, this should include every service, every item, every upcharge and every $25 aspirin that you were given.
These were all input by humans into your file at some point or another, so it's not uncommon for the bill to contain an honest mistake: an incorrect billing codes, a procedure that the doctor recommended but you never received, or a duplicate entry.
If anything is incorrect, call the billing office, inform them of the correction, and ask for a new bill to be issued. They may need some time for the doctor's staff to review your file, but they'll eventually issue you a new bill. Even if it doesn't lower it by much, it should buy you some time.
3. Haggle
What's one thing UCLA Hospital has in common with that sketchy sushi place near the LAPD station in North Hollywood? Cash discounts.
UCLA, like every medical provider, has a wide spectrum of amounts it charges for any one service. If you're uninsured, insured, paying cash, or just a chump who signs on the dotted line, UCLA has a number that's right for you.
So that first number they give you on the bill? Well, maybe that's not what you're feeling. Plug the medical codes on your bill into UCLA's charge master to see if there are other rates for the care you received, and see if they'll accept that rate instead.
If not, try researching how much that same procedure costs elsewhere.
An echocardiogram, according to the medical search engine turquoise.health, can cost as little as $274 or up to $6,564 within 10 miles of Studio City. If you have evidence that your procedure costs less at a different facility, your billing agent may agree to a price closer to that amount.
"It's one appendectomy, Michael. What could it cost? $10?"
If you don't want to use a 3rd party search engine (because, let's be real here, who knows how closely the cookies on those sites are treading the HIPAA line with the search data they store), google nearby hospitals with the phrase "charge master", where you can find their cost for your procedure and see how royally you were ripped off. Then use that information to ask your agent if they can lower the cost to one more reflective of the (cough - yet another term I hate) street rate.
4. Ask for the Settlement Amount
If the billing department won't lower the price of any individual line item, and if you're able to pay off part of the bill just to have this off your plate once and for all, you can ask your representative for the settlement amount - a one-time payment that will completely pay off your debt and zero-out your balance. How the representative gets this number hasn't been disclosed, but it can represent a discount anywhere from 30-50% off the original bill. If you don't like the number you're quoted today, thank the rep for their time and call back tomorrow. You might get someone else who's able to settle for thousands less. Or not. In which case, call back again. Rinse, repeat.
5. Request a Payment Plan
If all else fails, hospitals are open to discussing payment plans (as opposed to the alternative—selling your debt to a collector). Talk to them about what you can afford and see if you can do anything to avoid putting it on a credit card or having it sent to collections.
Nothing is Rational
As SCs and WAs, we're often used to being the most rational voices in the room. And we approach our lives the same way. We see our Spectrum bill or a reminder to pay our lease and...we do it. The idea that we would come back later to try to negotiate to pay less just...because? It's anathema to us.
And I get it.
But the volatility in the costs of medical procedures and the comedically high rates and discounts you see on your Explanation of Benefits go to show that it's all made up. There's no grounding in reality for these numbers. A Band-Aid shouldn't cost $629. And there's nothing dishonorable or weird or shameful about not wanting, or not being able to, pay that. Especially when you haven't collected a paycheck for three months. So don't. Use the soft skills and methodologies you've been developing for years to advocate for yourself. Just be polite, don't get heated, and remember you're talking with another human being - one who probably regrets their life choices, just like you.
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