Elderly patients are racking up huge medical bills, and many don’t realize it’s due to a secret trick hidden in hospital billing practices. This is known as “out-of-network underpayment,” costing patients and hospitals millions of dollars. When hospitals accept payments as low as 10-15% of bills from non-contracting insurance companies, patients often get stuck with balances. The No Surprises Act exacerbates this strategy, leaving seniors vulnerable to unexpected debt and financial stress.
How the No Surprises Act Creates Loopholes
The No Surprises Act is designed to protect patients from unexpected medical bills. But in reality, it creates a loophole that allows non-contracting insurance companies to reimburse hospitals at significantly reduced rates. Some insurance companies are now paying only 10-15% of the cost, instead of the 50-80% they normally charge. Hospitals typically accept these payments without objection, and the patient is responsible for the rest. Older adults on fixed incomes are especially at risk.
Why older patients are most affected
Seniors often require more frequent and complex medical care, making them prime targets for billing discrepancies. Many people rely on Medicare Advantage or supplemental plans, but these plans may not fully cover out-of-network services. When a hospital accepts low reimbursement, the remaining balance can be passed on to the patient. With limited financial flexibility, seniors may face debt, delayed care, and even bankruptcy.
The role of upgrade and billing errors
In addition to underpaying, some hospitals engage in “escalation”—charging more than what is actually performed. This practice can increase bills and potentially lead to disputes with insurance companies. Elderly patients may not have the resources or knowledge to challenge these accusations, especially when dealing with complex medical conditions. The result is a growing wave of medical debt among seniors.
What you can do to protect yourself
After each visit to the hospital, ask for a detailed itemized bill first. Compare this to the Explanation of Benefits (EOB) provided by the insurance company. If you notice a discrepancy or charge for service you have not received, please dispute it immediately. You can also ask if your provider is in network before receiving care. If you’re on Medicare, consider working with a patient advocate or billing expert to review your fees. Awareness is your first line of defense.
Hospitals are losing millions, but patients are losing even more
While hospitals are left with millions of dollars in losses by accepting lower out-of-network payments, patients are often left to foot the difference. This silent billing technique is draining retirement savings, delaying care, and causing unnecessary stress. Seniors deserve transparency and protection, not unexpected bills and financial losses. Now is the time to demand better billing practices and stronger oversight.
Have you or a loved one received an unexpected hospital bill? Share your experiences or tips in the comments – we’d love to hear how you deal with it.
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