Responsibility for Medical Bills

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It is sometimes difficult to understand where the responsibility lies for payment of medical services. Sometimes the insurance company pays, sometimes the patient does, and sometimes the patient is a minor child who can't be expected to pay for his medical needs. There are rules, however, that usually make the responsibility of payment for medical bills clear cut, and patients should know what those rules are.

Guarantor

  • Literally, guarantor means one who guarantees. In the medical field, the guarantor is the person responsible for paying medical bills. For adults, a good rule of thumb is that each adult is responsible for himself. Even if a wife is covered under her husband's insurance plan, the wife is generally responsible for any amount the insurance does not pay, not her husband. There are instances, however, when a court can rule otherwise.

Insurance company

  • In her textbook "A Guide to Health Insurance Billing," Marie Moisio defines health insurance as a "contract that provides money to cover all or a portion of the cost of medically necessary care." Having insurance doesn't eliminate financial responsibility. Often, patients have to pay a co-payment (fixed percentage or dollar amount) at each visit. Most insurance companies require patients to pay yearly deductibles before they will start paying anything. These co-payments and deductibles are the responsibility of the patient, and are often due the day services are rendered.

Minor children

  • Children whose parents are unmarried or divorced incur medical bills, and the responsibility for payment can seem tricky. Moisio writes, "Divorce decrees often address this responsibility by naming which parent has medical financial responsibility for the minor." In the absence of a divorce decree or other court order, the residential parent usually holds financial responsibility for the children. Medical institutions don't like to get in the middle. If a court document is not present at the time of service, a staff member might ask whichever parent is present to pay.

Guardianship

  • Dealing with guardianship is a lot like dealing with minor children. A court order is usually necessary to determine proof of financial responsibility. As stated, each adult usually pays for himself, but if a person has signed a document giving financial medical responsibility to another person, that person must pay. Don't confuse financial medical responsibility with simple medical decision-making responsibilities. Just because a person can make decisions for someone doesn't mean they are financially responsible for them.

References

  • "A Guide to Health Insurance Billing"; Marie Moisio; 2001
  • Photo Credit Stockbyte/Stockbyte/Getty Images
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