Dealing With Medical Refunds

When you have a child with special medical needs, medical bills can add up every year. But last year, we had extra bills for myself too. 

In April, I realized we had a problem. 

Our insurance plan said we wouldn’t have to pay more than a certain amount of money on medical bills for the entire year, but we had already paid much more than that. I made the first of many calls to my insurance company and doctors to figure out what happened. 

It turns out we had paid thousands of dollars more on medical bills than what we owed. We had to ask hospitals and doctors to pay us back the extra money. Correcting this took a lot of time, and we haven’t gotten all the money back — even now, a year later.

Insurance and medical billing are complicated. Many patients will pay more than they owe at some point and will need to ask for the extra money back. I had a lot of practice this last year. So, here are my tips for dealing with medical refunds:

• Learn about your insurance. If you know how much your plan pays for different services, you can spot when a bill seems too high. The Texas Department of Insurance provides information on health insurance options and why you should have health insurance.
• Pay later. Ask if you can pay your part of the bill after the doctor has billed your insurance. This buys you time to make sure the bill is correct.
• See how much your insurance paid. For every medical bill, your insurance company can tell you how much they paid and how much you should have paid. 
• Ask for refunds. If you paid more on the bill than your insurance says you should have, call the doctor or hospital to ask for a refund. This is important because many places keep the extra money in your patient account for future bills instead of giving it back to you. But you must ask for it.

For a deeper dive into insurance, check out our Insurance & Financial Help page.