Whether you’re undergoing tests and appointments to get a new medical diagnosis, dealing with the aftermath of an unexpected health issue, or managing a long-standing condition, the bills that come from any of these scenarios can be stress-inducing.

In the United States, where there’s vast discrepancies among healthcare costs and payment processes depending on your insurance company, insurance plan, and provider, it can feel particularly tough to plan for and navigate health expenses.

“Patients can leave their primary care provider office or a hospital thinking they have paid all of their expenses, only to receive an overwhelming number of residual medical bills from every provider involved in their care,” says Brandy Porche, a licensed professional counselor who provides marital and family counseling in McKinney, Texas.

The hard-to-predict nature of medical bills, coupled with the fact that their totals can range from burdensome to crippling, creates a lot of financial stress.

And often, that’s on top of the stress of living with a health condition in the first place. “Having a chronic medical condition requires adjustment and mental reframe,” Porche says. That’s especially true for newly diagnosed patients.

Every condition is different, but in many cases there's an ongoing need for medication and doctor’s visits, chronic pain or fatigue, and the extra time and effort it takes to do things that most folks without chronic illness do without a second thought.

“The added stress of financially affording the expenses of your condition can sometimes be debilitating,” Porche says. Questions may come up like: Can I afford to pay for the medications and care I’ll need? How much of the cost will my insurance cover, and will that amount change over time? What am I going to have to sacrifice or give up to be able to pay these bills? And, what happens if I simply can’t?

Unlike many other expenses that you might be able to cut back on when you’re financially strained, lowering your medical expenses isn’t always possible, Porche says.

Plus, medical billing can be confusing. Even if you have insurance, there may be surprise costs, and the price of visits and medication can vary between providers and fluctuate over time without warning, says Michael Botta, PhD, a health economist and a cofounder of Sesame, a healthcare marketplace that helps people find the best price for out-of-network medical care.

Even if you call your insurance company and healthcare provider ahead of a visit, there’s no guarantee you’ll be able to find out the true cost of that visit (or plan for it) ahead of time.

All that said, there are ways to stress less about medical bills. Here are a few expert tips.

1. Ask About Payment Plans

If you get a massive medical bill, Porche recommends being proactive about asking for a payment plan. “Upon receiving the bill in the mail, call the billing office and set up payment arrangements if you cannot afford to pay it in full,” she says, adding that sometimes these arrangements can break a bill up into payments as low as $10 per month.

“Do what is affordable for you,” Porche says. “Decide on a total amount per month that you can put towards the medical bills, then divide that total among all your current and outstanding bills.” Knowing how much you owe and having this kind of plan for paying is very helpful in relieving financial stress.

2. Take Advantage of HSA or FSA Options Available to You

“Talk to your employer about a health savings account (HSA) or flexible spending account (FSA), which you can fund with pretax dollars from your paycheck,” Dr. Botta says. “When unpredictable expenses come up (often things like urgent care or hospital stays), you can apply money from your HSA or FSA toward any medical bill.”

An HSA or FSA can eliminate the worry about surprise expenses, because you know you already have at least some money set aside to pay for them. “If your employer doesn't offer one, create one on your own or talk to your employer about sponsoring one for employees,” Botta says. “Companies like HSA Bank and Health Savings Administrators offer individually funded HSAs, and you can set up a regular contribution from your paycheck.”

Yes, you’ll still be paying the same amount for your care. But regular contributions to these accounts will mean you’re saving for future health expenses, which can soften the blow when they come.

3. Get a Good-Faith Estimate

To minimize your chances of getting a surprise medical bill after the fact, Porche recommends calling your provider prior to scheduling an appointment and asking about the cost of any procedures or medications. “Be sure to ask, ‘What possible costs can I expect from third-party providers or vendors?’ as well,” Porche says.

If you’re not planning to use insurance to pay for medical services, providers are required by law to give you a good-faith estimate before your visit. This is a new requirement that went into place on January 1, 2022, as part of the No Surprises Act.

The Centers for Medicare and Medicaid Services (CMS) explains that a good-faith estimate must include an itemized list with expected charges for services and items related to your care. And, if you get a bill that’s at least $400 more than your good faith estimate, you can dispute that bill.

4. Call Your Insurance Company Before a Medical Visit to Ask What’s Covered

Unfortunately, the No Surprises Act only applies to out-of-network providers, so it doesn’t help protect against surprise costs associated with copayments, deductibles, or other fees you might owe even when your insurance company covers something.

If you want to know what these costs will be, ask your provider (or, more likely, their billing department) if they’ll verify your benefits with your insurance company and let you know how much you might owe.

“Providers can confirm eligibility and benefits with health [insurance] plans for the services they plan to provide,” says Robert Julavits, the executive director of external communications at Athena Health, a medical practice management software company that offers medical billing services. They can find out from your insurance company, and then pass along to you, which services will and won’t be covered.

For example, your insurance company might cover the cost of an intrauterine device (IUD), but not the cost of the in-office procedure to place the device in your uterus. Your provider (or their billing department) should be able to confirm that information with your insurance company, and then share that information with you so that you can decide whether or not to move forward.

If you decide to verify your own health insurance coverage, Julavits recommends asking about your deductible, copay, co-insurance, and any other financial obligations you might have for a given procedure, as well as any prior authorization or referral requirements. “Patients should also verify there are no limits on payments if there are complications, and check if the entire care — from pre-visits to the procedure or service to follow-up or rehab — is covered.”

When verifying coverage with your insurance company, you can ask your provider for a script to use when asking about coverage for a certain procedure or type of care, Julavits says.

5. Allocate Time to Think About (and Deal With) Medical Bills

All the aforementioned steps take time, particularly the ones that require phone calls (and waiting on hold for the next available representative). Be realistic that those calls and to-do items on your list aren’t going to happen in five minutes at the end of your day.

“Allocate certain time to strategize on your medical debt,” suggests Rosario Chacón, a certified financial planner and financial behavioral specialist based in Oakland, California.

Depending on the size of your medical bills or medical debt — or the scope of your questions — you might schedule an hour or two every week, month, or quarter to assess them and look into the best ways to deal with them.

6. Seek Help

Chacón recommends looking around for helpful resources, whether that’s a financial planner who fits within your budget, a payment plan option as Porche suggested, or something else.

“A financial planner or financial therapist can give a more objective point of view on paying off current bills and strategizing for future ones,” Chacón says. They can help you work out a specific debt repayment plan, guide you in setting a budget, and explore any loan refinancing options that might reduce interest on your debt.

You could also seek out the help of a patient advocate (sometimes called “health advocates”). These professionals specialize in insurance and medical billing assistance. There are many different types of patient advocates, and they can help with everything from medical decision-making to navigating long-term healthcare, explains Adria Gross, the author of Solved! Curing Your Medical Insurance Problems and an advocate who specializes in medical insurance billing.

Like some other medical billing advocates, Gross has experience working for health insurance companies. “Now I help clients navigate all their medical bills and negotiate fees for medical care,” she says, explaining that medical insurance advocates can help with things like medical bills; denied, overcharged, or out-of-network claims; denials for long-term care policies; and fighting loss of insurance coverage while in a rehabilitation facility that a patient can’t physically leave.

To find an advocate with medical billing expertise, go to the Umbra Health Advocacy directory.

If you get health insurance coverage through your employer, someone in your human resources department may also be able to help you navigate your benefits and settle disputes that arise with your insurance company. But Gross says that most HR professionals aren’t trained to navigate the medical billing system, so they may not be able to help with more complex matters.

7. Give Yourself Grace

In addition to taking the necessary steps to reduce medical debt, Porche says it’s important not to blame yourself for your situation. Medical care in the United States is difficult to access, and the expenses of a chronic condition or a medical emergency are often out of each individual’s control.

This doesn’t mean you can ignore medical bills, but it can help combat the shame that you may feel around debt or the complexity of understanding the payment and insurance process.

Worried About Your Medical Bills? 7 Tips on Coping With Health Expense Stress