Few things spike stress like an unexpected bill — especially when it’s tied to health. One surprise charge from a hospital or lab can wreck an entire month’s budget, throw off savings goals and create lasting financial strain.
According to a recent study by Tebra, 45% of patients received unexpected medical fees last year. And the Consumer Financial Protection Bureau’s Making Ends Meet in 2024 survey found that 2 in 5 households struggled to pay a medical bill. With rising costs and the uncertainty of what will be covered, it’s no wonder people are hesitant to seek care. In fact, 44% said a surprise medical bill meant they couldn’t afford basic essentials, per Tebra.
Read Next: Money Influencer Vivian Tu: How the Rich Negotiate Their Medical Bills and Pay Less
Check Out: 7 Wealth-Building Shortcuts Proven To Add $1K to Your Wallet This Month
The good news? There are ways to sidestep the financial traps hiding in healthcare.
Ask for the CPT Code Before Anything Gets Done
Every medical procedure has a Current Procedural Terminology (CPT) code. Insurance companies use it to decide what’s covered and how much they’ll pay.
Asking for the CPT code and calling the insurer to confirm coverage can flag anything that might not be covered before the procedure happens — not after.
Learn More: 6 Bills the Middle Class Shouldn’t Put on Autopay, According to Experts
Get a Full, Itemized Estimate in Writing
Verbal estimates are useless when the bill arrives. Demand a breakdown in writing that includes all provider fees, facility charges, lab work and any specialist costs.
This can make it harder for providers to tack on mystery charges later.
Stay In-Network — Even When It’s Inconvenient
Emergency room physicians, anesthesiologists or labs may not always be in-network, even if the hospital is. Before agreeing to anything nonurgent, verify that every single provider involved is in-network. Otherwise, the bill won’t just be higher — it might not be covered at all.
Use the No Surprises Act To Fight Back
Federal law now protects against many types of out-of-network surprise billing, especially in emergencies, thanks to the No Surprises Act.
If a surprise bill shows up, it’s not always final. File a claim. Contest the charges. The protections exist — use them.
Double-Check Every Bill for Errors
Medical billing mistakes are common — and expensive. That $1,200 “lab fee” might be a coding error or a charge for something never performed.
Request an itemized bill. Question anything that looks inflated, vague or unfamiliar.
Push for a Preauthorization Every Time
Even when something looks covered, insurance might still need preapproval. Without it, claims can be denied entirely. Providers may want to skip this step, so making sure it’s done before anything moves forward is key.
According to Tebra, 61% of patients delayed care because they feared surprise bills. This hesitation can lead to worsened health outcomes and even higher costs in the long run.
The system isn’t designed for transparency — but that doesn’t mean patients are powerless. The more informed the approach, the less chance there is of an unexpected, nasty surprise.
More From GOBankingRates
- Mark Cuban: Trump's Tariffs Will Affect This Class of People the Most
- 5 Things You Must Do When Your Savings Reach $50,000
- How To Get the Most Value From Your Costco Membership in 2025
- 7 Wealth-Building Shortcuts Proven To Add $1K to Your Wallet This Month
This article originally appeared on GOBankingRates.com: 6 Ways To Avoid Getting Stuck With a Surprise Medical Bill
The views and opinions expressed herein are the views and opinions of the author and do not necessarily reflect those of Nasdaq, Inc.
