What happens if I don't pay a medical bill?

  • by *Flutter*
  • Apr 20,2018
  • 10 answers

I've been going to the same doctor for nearly 3 years. I've had Medicaid the entire time as well. I already had one doctor's visit this year and there was a problem with my insurance (it just needed updating). However, when I was trying to get everything straightened out, I was informed by my doctor's office that they do not accept Medicaid. I asked if this was a recent change and they ignored my question.
Today, I checked the mail and received a bill from them for $200, which should have been completely covered by my insurance.
I'm going to call them tomorrow, but why should I have to pay this? How was I supposed to know they suddenly stopped accepting my insurance?


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Insurance Answers (10)

mbrcatz 5 months ago

If they don't take state welfare (which is what Medicaid is), then your "insurance" isn't going to pay anything - you will have to pay it. If you don't, they'll tak eyou to collections just like an unpaid credit card goes to collections.

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curtisports2 5 months ago

If the same doctor you never had a problem with before made a decision to stop accepting Medicaid, they were required to advise you of this BEFORE you made that last visit. Contact your plan administrator, whoever that is, the county or state, whoever. Should the doctor take you to collections over this, you have the right to have your defense to this placed in your credit file. Doctors do not have to accept Medicaid, but if they have been accepting it from a particular patient and they decide to stop taking Medicaid, they must inform the patient before seeing them again, not after the fact.

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Flower 5 months ago

Medicaid is not health insurance. You have one or the other. The doctor's office may have stopped accepting Medicaid. The doctor probably doesnt know. They should have informed you if they dont take Medicaid. Are you talking about private insurance as well?

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StephenWeinstein 5 months ago

You were supposed to ask before you went.
If you do not pay, the bill goes to collevctions, you get harassed by collection agencies, your credit is ruined, the cost of your car insurance goes up, you cannot get loans or credit cards. And you better like where you live enough not to want to move for at least 7 years, because you cannot get a mortgage or rent most apartments. Or get hired for some jobs.
Not paying will cost you a lot more than just $200.

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Zarnev 5 months ago

Casey Y is 100% correct. Legally, they are not required to tell you anything. Also legally, you are responsible for charges that occurred when your welfare coverage lapsed and you are responsible for charges through providers that do not accept Medicaid.
If you don't pay they can send you to collections.
All of that being said doctors want to get paid so in most cases (at least in my area) if a provider is not contracted they'll tell you up front. My guess is there is more to this story as well.

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lucy 5 months ago

https://health.usnews.com/health-care/pa...
I could not find (if) the provider must notify or not, if they accept Medicaid anymore, but found this site that applies to (any) health insurance company. This is a common practice of providers adding/deleting insurance on/off their list. With Medicaid in particular has the (lowest) reimbursement rate to the providers, thus in many cases is hard to find (one) that will take you and could be limited to the (few) who accept it.
But as a general rule, if they take Medicaid and then stop, then they won’t take (new) patients, but (might) keep the few old patients. According to this article, they should have notified you, but they are (not) mandated to do so.
You stated that at the visit you was having problem with your insurance since you had not updated it, thus, at that point, they may have considered that you no longer have Medicaid anymore, thus treated you and then billed you.
Hopefully you get this resolved asap, but if not, then you could be on the hook for this bill, so be prepared, or they can put this in collection. If you do, then set up payment arrangements and find (another) doctor that accepts Medicaid.

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Casey Y 5 months ago

Commenters...Stop using words like "should" because that does not imply a legal responsibility, just a moral one. I agree, they "should" have notified you from a moral perspective, but were they required by law...probably not.
The treatment received may have been covered, but you admit your coverage was lapsed at the time of your visit anyway...perhaps there is more to this story.

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Crazy 5 months ago

If they told you, in the beginning, they accepted Medicaid they should have informed you in writing and in advance, they are stopping accepting Medicaid. I would tell them they will get paid after you submit a claim and not before.

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CYD 5 months ago

you get SUED

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vivienne 5 months ago

U pay them, and give the bill to your insurance and they will reimburce u

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