What to do if you get hit with a medical expense you can't afford

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Last week, I woke up on a day like any other, ready for a day of research, interviews, and writing, when I realized that one of my teeth had broken overnight—and was preventing me from being able to speak. As you can imagine, not being able to move my jaw on that day was quite worrisome, so off to the emergency dental office I went. After a fairly pricey consultation and x-rays, I found out I was going to need some significantly pricey dental work. To someone like me — who doesn’t have the means to drop several thousand dollars on a surprise procedure — news like this is pretty overwhelming. And it’s not something I can just opt out of. So, how do I handle this unexpected medical expense?

“Accidents happen, and if we find ourselves with a large medical bill the best thing we can do is work with the provider to see what payment plan options are available,” says Lauren Anastasio, a Philadelphia-based financial planner at SoFi, a personal finance company. She warns against using a credit card or depleting your emergency fund before speaking to your physician's office (like I was planning to). “Explain that the bill has the potential to cause you financial hardship but that you want to work with them to pay what you owe,” she says.

Medical debt is common, especially in America, where a 2018 study found the average hospital stay was $5,220 per day. Luckily for me, my procedures are outpatient only, but if a hospital stay ends up inflating your bill, payment plans in many cases come with a very low or no interest rate. “It may be a very attractive option to opt for a payment plan that will allow you to spread the financial obligation over the next few years, instead of depleting your hard-earned savings all at once,“ Anastasio says. She’s reading my soul, this one.

Another thing you can do — if you’re employed and insured that is — is rely on an employer-backed savings account. “Many employers offer flexible spending arrangements, or FSAs, which allow employees to pay for some medical expenses with pretax dollars,” says Michael Micheletti, a San Mateo, California-based finance expert with Freedom Financial Network, an online finance company. An FSA, which is typically offered through an employer, allows you to put money into an account to pay for copayments, deductibles, some drugs and other healthcare costs.

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The other arrangement that you can get through an employer is an HSA, or health savings account. “A qualifying high-deductible insurance plan allows you to pay medical bills with pre-tax dollars, and your medical expenses in a given year are high enough, they also might be tax-deductible,” Michelletti says, adding that if you're organized with keep record of your bills, it’ll be easier to take advantage of these benefits.

There are other techniques to dealing with a surprise medical expense that were offered to me by the many financial experts that could be incredibly useful to those who don’t get health insurance through their employer and who don’t have a giant vat of savings to dive into, a la Scrooge McDuck.

First, you can save on medications by consulting discount stores, and in some cases even auto clubs and college alumni groups offer discount prescription plans. Another thing you can do is consult a doctor-in-training center, such as a dental school in your area. As a DC-area resident, I found that Howard University offers discounted care supervised by experienced dental experts for me. Finally, as with any big financial move, make sure you’re comparing prices. Getting a second opinion is crucial. In my case, I consulted a second dentist, who looked at my x-rays and offered a completely different plan of care—one that was cheaper.

Hindsight is 20/20, so for those of us who are in good health at the moment: Start saving now, however your method. “Having time to prepare for a procedure gives you the opportunity to be strategic about how you’ll cover the expense,” Anastasio says. Luckily for me, my procedures aren’t immediately urgent, although I am going to need to do them soon. “Depending on your timeline, you may be able to make adjustments to your benefits in anticipation of the procedure,” she adds.

Through a health savings account, a normal savings account, or insurance, preparing for those rainy days are important. We’re all gonna need the help of a medical professional eventually. Preparing for this go around would’ve saved me undue stress, and starting saving now will certainly save me from heartache down the line.