Inaccurate Medical Billing Creates Problems for Older Adults

Even though most older adults have health insurance, they’re facing increasing medical debt, reports the Consumer Financial Protection Bureau. Older adults face a complex billing system with a high likelihood of errors and inaccurate bills, according to the bureau. 

The CFPB examined census data along with consumer complaints received between January 2020 and December 2022. It says its findings suggest that providers are billing older dual beneficiaries of Medicare and Medicaid for amounts they don’t owe.

The report found that in 2020, nearly 4 million adults 65 and older reported having unpaid medical bills, even though 98% of them had insurance. Nearly 70% of these older adults with unpaid medical bills also reported having medical insurance coverage from two or more sources.

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The reported amount of unpaid medical bills among older adults increased by 20% between 2019 and 2020, from $44.8 billion to $53.8 billion. Yet older adults reported fewer doctor visits and lower out-of-pocket expenses in 2020 than in 2019.

What to do when you get surprise medical bills 

The No Surprises Act bans unexpected out-of-network medical bills for emergency room visits or out-of-network bills when receiving treatment in an in-network hospital or other facility. 

If you don’t have insurance, the law usually requires providers to give you a good faith estimate of how much your health care will cost if you schedule services at least 3 business days in advance or you request one. You may be able to dispute your bill if it’s at least $400 more than the estimate.

To help consumers understand their rights and protections under the law, the Centers for Medicare & Medicaid Services has information about its requirements, an interactive tool to help consumers identify actions they can take to resolve their billing issues, as well as a complaint form to report a violation of the rules at the CMS website. 

Note: This item first appeared in Kiplinger’s Retirement Report, our popular monthly periodical that covers key concerns of affluent older Americans who are retired or preparing for retirement. Subscribe for retirement advice  that’s right on the money.