Chrystal McKay knew enough about medical care costs that she skipped the ambulance ride after a car accident. A friend drove her to the emergency room.
That saved her one bill, but she faces another for more than $20,000 after her ER visit. The 29-year-old Stockton, California, woman must balance paying her debt with getting care for a sprained shoulder that may need surgery: "I have to weigh the pros and cons. I'm already $20,000 in debt, and any more treatment will just put me more in debt."
Uninsured at the time and facing a bill she doesn't know how to handle, McKay finds herself in a position familiar to many in her generation. If she can't cover the cost, her bill may wind up in collections.
No matter your age or insurance status, there are ways to make medical debt more manageable, whether you just got the bill or it's already in collections.
Medical collections peak in late 20s
Young adults incur medical collections debt at a higher rate than older age groups, according to a study published in Health Affairs, a health policy journal.
Among the reasons younger adults are prone to this kind of debt:
•Less earning power: Americans ages 25 to 34 had a median income of $36,664 in 2017, according to the Census Bureau's Current Population Survey.
•Lack of insurance: Less than 20 percent of millennials in their late 20s and early 30s were uninsured, the highest rate seen in the Health Affairs report.
•Mobility: Younger people tend to move more frequently, increasing the chances for lost bills leading to collections.
Uncertain how to cover medical bills
If your bill isn't paid for several months, the debt could go into collections, which can drag down your credit score and make you appear riskier to potential creditors.
"I find, by and large, people have no clue about how to handle a bill," says Adria Gross, a medical bill advocate in upstate Monroe. In nearly 30 years of experience, she's seen the confusion medical bills can cause.
"First thing people need to do if they can't afford a bill is call their provider and see if they can negotiate it. And the provider probably can reduce what you owe," Gross says. She advises having details of your income and how much you can pay at hand, to help you make your case.
Other options for handling your medical debt include:
•Pursue a payment plan: Ask the provider to break up your bill into a number of payments to cover the cost over time. If they refuse, you can create your own by transferring the debt to a 0 percent APR credit card (though you'll need good credit to qualify for one).
•Hire a professional: Medical bill advocates might be able to negotiate your bill down to a fraction of the original amount.
To settle medical debt, you might be able to negotiate a lump sum settlement on your own, especially if the debt is already in collections. The creditor may accept your offer to pay less than you owe rather than risk receiving no payment at all.