Emmarie Huetteman
A Texas boy’s second dose of the MMRV vaccine price over $1,400. A Pennsylvania lady’s long-acting birth control price greater than $14,000.
Treatment for a Florida Medicaid enrollee’s heart attack price almost $78,000 — about as a lot as surgical procedure for an uninsured Montana lady’s broken arm.
In 2025, these sufferers had been among the many tons of who asked KFF Health News to research their medical payments as a part of its “Bill of the Month” collection.
Insured and uninsured. Job-based and government-funded. Comprehensive and short-term. Part of a sharing ministry. So many individuals with totally different medical health insurance conditions requested the identical questions: Why do I owe a lot? And how am I going to afford it?
As tens of millions of Americans grapple with the rising price of medical health insurance subsequent yr, the “Bill of the Month” collection is approaching its eighth anniversary. Our nationwide workforce of well being reporters has analyzed virtually $7 million in medical fees, greater than $350,000 of that this yr.
Of this yr’s 12 featured sufferers, 5 had their payments largely or totally forgiven quickly after we contacted the supplier and insurer for remark.
Our mission, although, is to empower each affected person with the data wanted to grasp, handle, and — if push involves shove — battle their very own medical payments. Here are our 10 takeaways from 2025.
1. Most insurance coverage protection doesn’t begin instantly. Many new plans come with waiting periods, so it’s essential to take care of steady protection till the brand new plan kicks in. One exception: If you lose your job-based protection, you have got 60 days to choose into a COBRA policy. Once you pay, the protection applies retroactively, even for care obtained when you had been briefly uninsured.
2. Check out your protection earlier than you examine in. Some plans include surprising restrictions, doubtlessly affecting protection for care starting from contraception to immunizations and cancer screenings. Call your insurer — or, for job-based insurance coverage, your human assets division or retiree advantages workplace — and ask whether or not there are exclusions for the care you want, together with per-day or per-policy-period caps, and what you possibly can count on to owe out-of-pocket.
3. “Covered” doesn’t imply insurance coverage can pay, not to mention at in-network charges. Carefully learn the tremendous print on community hole exceptions, prior authorizations, and different insurance coverage approvals. The phrases may be limited to sure medical doctors, providers, and dates.
4. Get a value estimate in writing for nonemergency procedures. If you object to the worth, negotiate before undergoing care. And if you happen to’re uninsured and obtain a invoice that’s $400 or greater than the estimate, the federal Centers for Medicare & Medicaid Services has a formal dispute process.
5. Location issues. Prices can range relying on the place a affected person receives care and the place assessments are carried out. If you want blood work, ask your physician to ship the requisition to an in-network lab. A health care provider’s workplace connected to a health system, as an illustration, might ship samples to a hospital lab, which might imply increased fees.
6. When admitted, contact the billing workplace early. If potential, once you or a beloved one has been hospitalized, it may possibly assist to talk to a billing consultant. Ask whether or not the affected person has been totally admitted or is being saved underneath statement standing, in addition to whether or not the care has been determined to be “medically necessary.” And whereas there could also be no selection about taking an ambulance, if a transfer to another facility is really helpful, you possibly can ask whether or not the ambulance service is in-network.
7. Ask for a reduction. Medical fees are virtually all the time increased than what insurers would pay, as a result of suppliers count on them to barter decrease charges. You can, too. If you’re uninsured or underinsured, you could be eligible for a self-pay or charity care discount.
8. There’s assist obtainable for Medicaid sufferers. If you get a invoice you don’t think you should owe, file a grievance along with your state’s Medicaid program and, you probably have one, your managed-care plan. Ask whether or not there’s a caseworker who can advocate in your behalf. A authorized support clinic or client safety agency specializing in medical debt may assist file complaints and talk with suppliers.
9. Your elected representatives may also help, too. While a name from a state or federal lawmaker’s workplace might not get your invoice forgiven, these officers typically have an open line of communication with insurance coverage corporations, native hospitals, and different main suppliers — and advocating for you is their job.
10. When all else fails … you possibly can write to “Bill of the Month”!
Most Insurance Covers IUDs. Hers Cost More Than $14,000.
By Julie Appleby,
January 31, 2025
The Affordable Care Act requires most insurance plans to cover preventive care, including many forms of contraception, without cost to patients — but not if they’re “grandfathered” plans, which predate the law.
A Runner Was Hit by a Car, Then by a Surprise Ambulance Bill
By Sandy West,
February 28, 2025
A San Francisco man had friends drive him to the hospital after he was hit by a car. Doctors checked him out, then sent him by ambulance to a trauma center — which released him with no further treatment. The ambulance bill? Almost $13,000.
He Had Short-Term Health Insurance. His Colonoscopy Bill: $7,000.
By Julie Appleby,
March 28, 2025
After leaving his job to launch his own business, an Illinois man opted for a six-month health insurance plan. When he needed a colonoscopy, he thought it would cover most of the bill. Then he learned his plan’s limited benefits would cost him plenty.
The Patient Expected a Free Checkup. The Bill Was $1,430.
By Samantha Liss and Lauren Sausser,
April 30, 2025
Carmen Aiken of Chicago thought their medical appointment would be covered because the Affordable Care Act requires insurers to pay for a long list of preventive services. But after the appointment, Aiken received a bill for more than $1,400.
A Medicaid Patient Had a Heart Attack While Traveling. He Owed Almost $78,000.
By Arielle Zionts,
May 29, 2025
Federal law says Medicaid must cover out-of-state emergency care. But a Florida man got a five-figure bill after a South Dakota hospital declined to charge his state’s Medicaid program.
A Texas Boy Needed Protection From Measles. The Vaccine Cost $1,400.
By Julie Appleby,
June 30, 2025
A family living in Galveston was surprised to be charged thousands of dollars for immunizations for their children. Their insurance plan didn’t cover the shots, and the cost of the measles vaccine in particular was more than five times what health officials say it goes for in the private sector.
A Tourist Ended Up With a Wild Bat in Her Mouth — And Nearly $21,000 in Medical Bills
By Tony Leys,
July 31, 2025
Health insurance generally doesn’t cover treatment for injuries sustained shortly before a customer buys a policy. A Massachusetts woman found that out the hard way.
An Insurer Agreed To Cover Her Surgery. A Politician’s Nudge Got the Bills Paid.
By Cara Anthony,
August 26, 2025
A kindergartner in Missouri needed eye surgery. Her insurer granted approval for her to see a specialist nearby, yet her parents were confused when they still owed more than $13,000. Then her uncle, a former state senator, reached out to a colleague who contacted the hospital and the insurer.
She Had a Broken Arm, No Insurance — And a $97,000 Bill
By Katheryn Houghton,
September 24, 2025
Deborah Buttgereit knew piecing together the broken bone in her elbow would be expensive. But complications the doctor deemed a surprise, midsurgery, drove the total bill tens of thousands of dollars above the original estimate.
Doctor Tripped Up by $64K Bill for Ankle Surgery and Hospital Stay
By Julie Appleby,
October 29, 2025
A doctor in Colorado became the patient after an accident totaled her car and sent her to the operating room. The hospital kept her overnight, but her insurer stopped paying after she left the emergency room.
Not Serious Enough To Turn on the Siren, Toddler’s 39-Mile Ambulance Ride Still Cost Over $9,000
By Tony Leys,
November 25, 2025
After her son contracted a serious bacterial infection, an Ohio mother took the toddler to a nearby ER, and staffers there sent him to a children’s hospital in an ambulance. With no insurance, the family was hit with a $9,250 bill for the 40-minute ride.
Scorpion Peppers Caused Him ‘Crippling’ Pain. Two Years Later, the ER Bill Stung Him Again.
By Elisabeth Rosenthal,
December 19, 2025
Homemade hot sauce sent a Colorado man to the emergency room with what he called “the worst pain of my life.” But stomach cramps were only the beginning. Two years later, the bill came.
Photographers
Jason ArdanScott DaltonLoren ElliottJamie Kelter DavisMatt KileJacob Langston
Maddie McGarveyParker Michels-BoyceSophie ParkJim VondruskaJeremy Wade ShockleyRachel Woolf
Bill of the Month is a crowdsourced investigation by KFF Health News and The Washington Post’s Well+Being that dissects and explains medical payments. Since 2018, this collection has helped many sufferers and readers get their medical payments decreased, and it has been cited in statehouses, on the U.S. Capitol, and on the White House. Do you have got a complicated or outrageous medical invoice you wish to share? Tell us about it!
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