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Updated June 10, 2015.

If you have recently had surgery you may have bills piling up in your mail.  Before you open them, and panic, take a deep breath and remember that these bills do not necessarily indicate how much you will owe.

Why So Many Bills After Surgery?

Many of the expenses of surgery are billed separately, as they are generated by different departments.  For example, you may receive one bill for anesthesia services, one for the surgeon’s fees, one for hospital fees, and another for lab fees.

 Unfortunately, surgery is very expensive and the charges may be billed by multiple offices in and out of the hospital. 

Don’t Pay The First Bill!

Your first bill doesn’t typically reflect the actual price of your surgery.  The subsequent bills, that show payment from your insurance company are much more likely to be accurate.  You want to pay the bill that arrives that indicates how much your insurance paid, and indicates “what you owe” versus the total bills.  This amount should be substantially lower. 

Why the First Surgery Bills Are Often Much Higher Than the Final Surgery Bill

The first bills that arrive are often the amount that is submitted to your insurance carrier, which means they have the highest possible prices listed.  Your insurance, whether it is private insurance, Medicare or some other type of health insurance, may have already negotiated an acceptable rate for these.  

For example, let’s say you have your appendix removed and the first bill shows $40,000 is what is owed for surgery.

  This bill is submitted to your insurance carrier, who may have negotiated a rate of $10,000 for that procedure.  That amount is $30,000 less, but you don’t owe the difference, it is a discounted rate. Think of it as a sale on surgery, no one is going to pay the discounted portion, not even you. 

So now the $10,000 is what your copay will be based on.  If you have a 20% copay, you don’t owe 20% of $40,000, you owe 20% of $10,000.  That means $2,000 instead of $8,000 in this case.  

What if You Don’t Have Insurance and Medical Bills Are Piling Up?

One of the first things you want to do if you had surgery without the benefit of insurance is to contact the hospital’s billing department.  Don’t be afraid of calling, working with the billing department can help prevent serious damage to your credit.  

First, find out if you could potentially be covered by a government plan or a program for uninsured patients. Some patients do qualify for Medicare, Medicaid and other programs that can provide huge benefits.

Second, ask them to offer you the same discount they offer major insurance companies.  As a cash paying patient, you may be billed the full amount (the $40,000 from the previous example) instead of a much lower amount that the hospital routinely accepts.  If you have the means to pay this bill, fantastic, but many people do not.  It is common practice for hospitals to set up payment plans for patients who have unexpected medical bills.  

Third, don’t ignore these bills! Pretending the bills don’t exist will mean they affect your credit.  Working with the hospital to pay a monthly amount, even if it is a small percentage of the total bill, will often protect your credit. The billing department is accustomed to dealing with financial issues and they are not the enemy, in fact, a friendly and helpful customer service agent in the billing department may be your new best friend when you find out just how helpful they can be, shaving thousands of dollars off of your hospital bill and establishing a payment plan (often interest-free) that works with your budget. 

What to Do When You Have Insurance But Still Can’t Afford Your Surgery Bills

If your portion of your surgery expenses something that you cannot afford even with your insurance coverage, talk to the billing department at the hospital.  Payment plans are very common for patients who have outstanding bills after seeking medical treatment.  Be honest about what your budget can accommodate, remember, the hospital would rather have small payments over time than no payments.  Paying out of pocket is painful, but can be done.

Don't forget to save receipts or canceled checks for any medical expenses as some health care expenses are tax deductible. You can also use your Flexible Spending Account to reduce your taxable income while paying medical bills.