vania-janet/multiturn-rag-retrieval-data huggingface dataset:
If they had told me that I owe them $10,000 from 3 years ago, I   wouldn't have anything to fight back. Why? First thing you have to do is ask for a proof. Have you received treatment? Have you signed the bill when you were done? This should include all the information about what you got and how much you agreed to pay. Do they have that to show to you, with your signature on it? If they don't - you owe nothing. If they do - you can match your bank/credit card/insurance records (those are kept for 7 years at least) and see what has been paid already. Can a doctor's office do that? They can do whatever they want. The right question is whether a doctor's office is allowed to do that. Check your local laws, States regulate the medical profession. Is there a statute of limitation (I'm just guessing) that forces them   to notify me in a certain time frame? Statute of limitations limits their ability to sue you successfully. They can always sue you, but if the statute of limitations has passed, the court will throw the suite away (provided you bring this defense up on time of course). Without a judgement they cannot force you to pay them, they can only ask. Nicely, as the law quoted by MrChrister mandates. They can trash your credit report and send the bill to collections though, but if the statute of limitations has passed I doubt they'd do that. Especially if its their fault. I'm not a lawyer, and you should consult with a lawyer licensed in your jurisdiction for definitive answers and legal advice.
I wouldn't classify your treatment as abuse. Medical billing has become more complex not less complex. You need to learn to ask even more questions regarding expenses, you probably need to see these price quotes in writing. You did several things correctly. Staying in-network generally is best because many plans have two deductible limits: In-network, and out-of-network.  You need to make sure that the insurance company does credit you with having paid the new patient fee. That will qualify as an expense toward the deductible and your maximum out of pocket for the year. Some doctors offices don't send to insurance companies items that they know will not be covered, not remembering that these costs are critical under the High deductible plans with a health savings account. Doctors offices have problems determining how much the cost to you will be. It depends not just on the insurance company but also which type of plan you have, which sub-plan you have, and are you covered by more than one plan. Not to mention individual deductibles, family deductibles, and annual out-of-pocket amount. All this is wanted prior to the doctor seeing the patient. Most doctors offices will work with you, they know that each insurance plan treats each medical billing code differently, sometimes they make a mistake. Talk to them.
"In addition to the good answers already provided, I want to point out that many (most?) providers will handle filing your health insurance claim for you even though it's really your responsibility. So here's how medical bills ""you don't have to pay"" might come about: * It's possible that your balance is $4, or $20, or $65, or even still $100 depending on your particular insurance plan. Whatever is left at this step is what you pay."
"What you have here is an interesting argument. Right now, this is totally complicated by the state of ""forced insurance"" that is currently in such hot debate right now.  As a general rule of thumb though, most Americans pay their medical bills in one way or another. Though It is also accurate to say that most Americans have avoided paying a medical bill at one point or another.  I will give an example that will help clarify. My wife gets a Iron infusion shot one every year or so. We choose not to have insurance. The cost to us is around $275. We know this upfront and have always paid it up front. Except for one year. One year we had insurance. The facility that does the infusions charged us $23,500 to do the infusion that year. The insurance paid $275 to them. We refused to pay the remaining  $23,225.  This is a real example using real numbers.  SO while we are more then able to pay the ""normal"" amount, and we could, in theory, pay the inflated amount, We out right refuse to.  The medical facility tried to negotiated the amount down to $11,000 but we refused. They then tried to talk us into a credit plan. We refused. Then they negotiated the entire thing down to $500. We refused. Finally, after 2 years of fighting they agreed that the service had been pair for by the insurance. And sent us a $0 bill.  The entire time, that facility was more then willing to keep doing this annual service for $275.At no time were we denied care. We did have a dent in our credit for a while, but honestly it didn't matter to us. Wrap Up It is fair to say that most Americans do pay their medical bills, but it is also fair to say that most Americans do not pay all their medical bills. The situation is complicated, and made more so by recent changes.  Heath insurance is the U.S. is nearly criminal and while some changes have been made in recent years the same overriding truth exists. Sometimes, a medical bill, when going through insurance, is just plain silly, and the only recourse you have as a customer is to not pay it, for a while, till you get it sorted out."
I'm going to echo Phil and say that you should add more information. That being said, I think it is possible for you to owe the government that much. If you received a federal health insurance subsidy and live in a state that didn't expand medicaid, you could have received a subsidy through out the year that you did not end up qualifying for. It appears you are outside the medicaid limit of 133% of the poverty level($11,670) or $15,521. If you received a subsidy of $275 a month from the marketplace, you would have received $3300 worth of aid from the government that you don't qualify for. Now they are expecting you to pay it back.
Actually I think direct financial kickbacks are a minor factor in this problem. In most cases a physician makes nothing from the writing of a prescription. What does influence a physician is the never ending attempts of pharmaceutical companies to 'educate' them. This goes far beyond simple drug reps visits given that most medical conventions and a goodly number of 'continuing education' events are manufacturer sponsored. There are many hidden benefits that flow from this tactic, and few could be expressed as 'direct payoffs'. It's a race between professional ethics and marketing tactics, and at least in the USA ethics are often left in the dust.  There is also another factor which may have even greater weight - the demand from patients, one's medical education/indoctrination and society in general to ''do something''. The value of literally doing nothing isn't emphasized enough in medical education; nor is it appreciated by the general public. Sometimes ''doing something'' is fairly benign. Wave your hands, prescribe a pill or engage in alternative/voodoo medicine. Most diseases will get better on their own despite the doctor's best efforts.   Once more this situation is at its worst in the USA. American physicians are notoriously aggressive and are very prone to overtreatment. Given the long standing and well documented failure of the American system to measure up in terms of outcomes compared to other countries this aggression has nothing but negative empirical support in its favour. The dismal performance of US  medicine isn't only because of its gross inequalities. There are other factors at play, and overtreatment is one. You won't necessarily get *better* treatment because you are either wealthy or have wonderful insurance, but you will definitely get *more* treatment.
no, i never said forgive student debts, i said give household massive money to pay back the debts.   so give students that owe loans pure unadulterated cash.   force them to use it to pay their student loans.     if the sutdent doesn't have debt, or was responsible and paid it back themselves using their own money, then they get a free cash injection to do whtever they want with it.    all's fair and square and beeswax.
Personal story here: I ended up at the Santa Monica hospital without insurance and left with a bill of $30k-$35k. They really helped me, so I felt like I had a duty to pay them. However, close inspection revealed ridiculous markups on some items which I would have disputed, but I noticed that I had been billed for a few thousands of services not rendered. I got very mad at them for this, they apologized, told me they'd fix it. I never heard back from them and they never put it in collection either. I'm assuming they (rightfully) got scared that I'd go to court and this would be bad publicity. Sometimes I feel guilty I didn't pay them anything, sometimes I feel like they tried to screw me.
Correct, but that's neither here nor there. I wasn't comparing the two.  I said you can payoff other debts (such as credit cards) through a refi. To do this, a payoff has to be obtained from the creditor just as you would if you just wanted to pay the account off yourself.
If you are disputing the size of the charge for specific services, like you think that they overcharged for lab work, you can try disputing it with the business office staff at the doctor's office. If, on the other hand, you just think that the overall bill is too expensive then you really only have one option. You can ask if they will reduce the bill for you. Most hospitals and clinics I've dealt with have programs set up for this, but you usually access them by filling out paperwork demonstrating financial hardship (along with supporting documents). It never hurts to ask. But with the services already rendered the only person with an interest in reducing the bill is you. The reduction, if any, will probably depend on what the clinic thinks your ability to pay is compared with the cost to them of pursuing you for payment, as well as the amount of funding they have for bill reduction. When I worked in the financial services office of a hospital a $400 bill would not even have been reviewed for discounting-- the balance would be too low to devote staff time to reviewing. It's frustrating, and even asking in advance might not have given you accurate (or any!) information on what the cost of the visit would be, so your ability to shop around is limited. Unfortunately, that doesn't give you any additional options in this case.
No danger. You can get in a car accident, break your leg skateboarding, or otherwise wind up in the hospital like anyone else.  You can also get the money back, with a tax penalty, but you probably will never need to if you are responsible and live within your means. Do you need a wake up call about what things can cost?  I knew a college student who broke his leg skateboarding and didn't buy the ~$100/semester health insurance.   He had to have a rod put in his leg and it was ~$30,000.  Obviously he didn't have the money and the hospital agreed to put him on some kind of payment plan.  I suppose bankruptcy was an alternative.... but either way, not a great way to start out in life.   Any time you can defer payment of tax for decades or buy something with pre-income tax money, it is like instantly earning 20% (or more) on your money.  I believe you can pay for eyeglasses and dental out of an HSA as well.  So I wouldn't go overboard on an HSA or IRA if you have big credit card debts, if you do have room for savings it is dumb not to be putting money in the HSA and IRA/401k. Take a look at HSA bank for a low fee home for your money. They pay interest on over $3,000 (but like most banks, not much).  The fees for being under $3k are currently around $2 a month.  Don't worry about investing the HSA money until you have like $10,000 in there, which will be a while.
"First of all, I'm happy that the medical treatments were successful. I can't even imagine what you were going through.  However, you are now faced with a not-so-uncommon reality that many households face. Here's some other options you might not have thought of:   I would avoid adding more debt if at all possible.  I would first focus on the the cost side.  With a good income you can also squeeze every last dollar out of your budget to send them to school.   I agree with your dislike of parent loans for the same reasons, plus they don't encourage cost savings and there's no asset to ""give back"" if school doesn't work out (roughly half of all students that start college don't graduate) I would also avoid borrowing more than 80% of your home's value to avoid PMI or higher loan rates.  You also say that you can pay off the HELOC in 5 years - why can you do that but not cash flow the college?   Also note that a second mortgage may be worse that a HELOC - the fees will be higher, and you still won't be able to borrow more that what the house is worth."
Standard Repayment can be quite burdensome. Fortunately, it looks like FedLoan Servicing offers a variety of payment plan options, and even provides a calculator that you can use to compare them given your adjusted gross income and current loan balances. This won't reduce that $420 to $0 but it may bring it down significantly.  I agree with @littleadv that you need legal advice to answer your other questions. That being said, I can tell you that it is possible to go into deferment and/or forbearance at any time (not only before you start making regular payments) as long as you meet the criteria.  Otherwise, it may be worth looking through other questions and answers on here about lowering expenses and increasing income. There is a lot of good advice for people in similar situations to yours. If you are truly in hardship, even with a full-time job, you may qualify for supplemental nutrition insurance, a.k.a. food stamps.  Best of luck.
If you've got the money to pay the bill today, do it. They are giving you a 25% discount if you do. You won't find an investment that will beat that.  Let's look at the details of your scheme.  Instead of paying $1696 today, you decide that you will pay $2261 over 60 months, or $37.68 per month.  You also decide to invest $1696 today, and expect to get 6% return each year. Your investment gets you $102 each year, but you have to pay taxes on that.  If you are in the 25% tax bracket, you only keep $76 (ignoring state taxes).  In addition, the loan is costing you $452 in payments each year. At the end of the 5 years, you will have paid $2261 to the hospital, and your $1696 investment will be worth about $2123 after taxes. Instead, let's say that you paid the hospital $1696 today, and invested the $37.68 per month.  At the end of 5 years, assuming the same 6% growth and 25% tax bracket, your investment will be worth $2552. In order for you to come out ahead by investing today and paying off the hospital over time, you would need to get at least a 17% growth on your investment.  If you are ignoring taxes, then the number you need to hit is at least 13%. Conclusion: You will come out ahead by paying the hospital today, and investing the monthly payment plan that you avoided. (Note: Bankrate has a very handy investment calculator that makes it easy to calculate returns on a monthly investment.) Now, let's look at the ethics of the situation.  Assume that you were able somehow to find an investment with a guaranteed return high enough to come out ahead with your plan.  Should you do it? The hospital has provided you a service, and you owe the money.  As a public service to people that cannot pay the bill, they allow people to pay off the bill over time at no interest.  However, you are not one of these people.  You have the money to pay.  It is not ethical, in my opinion, to use the hospital's money to invest and try to profit.
So how does that work when you're past retirement age? Do you just keep paying huger and huger sums for insurance, or are you covered by your pension plan (if you have one)?  Or do Medicare and Medicaid cover everything (i.e. you don't have to pay)? In which case if you move to Latin America, you could get stuck with a big medical bill, but not if you stay in the States?
There are some student loan repayment programs and the like where, if a raise would bump you past a certain threshold, you become ineligible and are suddenly left holding the whole bag, or alternately the payoff for having your loans forgiven/repaid drops considerably. It can make financial sense to avoid crossing those thresholds.
If you know the amounts that were combined ($5,000 and $7,500 in your example) -- NOT the original loan amounts necessarily -- then you can calculate a payment schedule (in Excel, Google Sheets, online, etc.) using that amount and the interest rate.  You can then apply your payments ($100) to that payment schedule, making sure to either accrue interest if your $100 didn't cover the monthly payment, or pay down extra principal if your $100 more than covered the payment.   The outstanding principal is the amount left or remaining balance. A program like GnuCash or Quicken makes doing the payment schedule, and applying payments relatively easy to handle.  Spreadsheets will require you to have 36 lines (3 years x 12 months) of payment and recalculation detail, but that shouldn't be too much work. To be fair to your mother, make sure you include any partially accrued interest on the full balance when paying it off.  Or even better, include a full month's interest in the pay-off amount.
A medical expense is only a qualified medical expense eligible for an HSA distribution if it is not reimbursed by insurance.  If you know that you will be reimbursed, do not pay for it through your HSA. Think of it this way: you can only be reimbursed for a medical expense once.  Either you get reimbursed by your insurance, or you get reimbursed by your HSA, but not both. If you pay for the expense with your HSA and are later reimbursed, you need to return the money to your HSA through a mistaken distribution repayment.  This is not considered a contribution, but you need to make sure to tell your HSA provider that it is a mistaken distribution repayment and not a contribution, so that it gets accounted for correctly.
Research and find out what Medicare pays, offer 60% of that, and haggle it to 100%. And sleep well knowing you paid what is fair. Not all services are as overpriced as my example, but most are at least 50% too high. The hospital does send you all the bills as a formality, even while they submit them to your insurance company. And then the insurance company usually pays them, so it is correct to ""not pay that bill"". A lot of medical offices will check with your insurance company even before you leave the office, and ask you to immediately pay anything the insurance won't cover. For instance they often have ""co-pays"" where you pay $20 and they pay the rest. To be clear: if your insurance company negotiates a rate with the hospital, say $185 for the ambulance ride, that is your price, which you are entitled to as a member of that insurance system. A lot of people get their livelihood from the inefficiency in medical insurance and billing. Their political power is why it's so hard for America to install a simpler system (or even replace Obamacare in an ideal political environment). It is also a big part of why America spends 18% of GDP on healthcare instead of 7-11% like our European peers who do not have to account for every gauze or rebill multiple insurers. Sorting out ""who pays"" would be expensive even if everyone did pay."
"The general answer to this is ""yes"". When you're dealing with single-digit millionaires, the answer is that their insurance habits and needs are basically the same as everyone else. When you get into the double digit and triple digit millionaires, or people worth billions, they have additional options, but those basically boil down to using ""self-insurance"" rather than paying a company for an insurance policy. The following is based on both what I've read and a fair deal of personal experience working for or with various stripes of millionaire, and even one billionaire. Addressing the types of insurance you mention: This is generally used to provide survivors with a replacement for income you can no longer provide when dead, in addition to paying for costs associated with dying (funeral, hospital/hospice bills, etc). Even millionaires and billionaires have this, yes, but the higher your net worth, the less value it has. If you're worth 9 or 10 figures, you probably already have trust funds set up for your family members, so an extra payout from an insurance policy is probably going to represent a small fraction of the wealth you're leaving your survivors, and as has been noted, insurance makes a profit, so the expectation by the insurance company is that they'll make more money on the policy than they'll have to pay out on death. That being said, the members of the 9+ figure club I've worked for all had multi-million dollar life insurance policies on them, which were paid for or heavily subsidized by the companies they owned or worked for. I doubt they would have held those policies if they had to pay the full cost, but when it's free or cheap, why not? Absolutely. As health insurance in America is an untaxed employment benefit, owing to regulations from World War II, all the wealthy folks I've had contact with got outrageously good plans as part of the companies they work for or owned. Having said that, even their trust fund beneficiaries held health insurance, because this type of insurance (in America, at least) is actually not really insurance, it's more of a pre-payment plan for medical expenses, and as such, it provides broader access to health care than you'd get from simply having enough money to pay for whatever treatments you need.
"What you are looking for is the ""debt maturity profile"" (to make it easier to google. Most countries continuously roll over their debt, in effect just paying interest forever. So when your debt is due, you issue another loan for the same amount and use the new loan to pay off the old one."
In the United States you can't, because the average millennial in the United States has no opportunity to save money. Either you get a college education, then you will be burdened with a student loan. The cost of college education skyrocketed in the past decades. It is now practically impossible to enter the workforce without a huge debt, unless you are one of the lucky few who has rich and generous parents. Or you skip college. But college is the only way in the United States to obtain a generally accepted qualification, so you won't get any job which pays enough to save any money. As soon as that student loan is paid off, you need to get another loan for you house which you pay off for several decades. As soon as the house debt is paid off, you will be old and develop some medical problems. The medical bills will come in and you will be in debt again. So when in their life are millennials supposed to save money?