How do you deal with a $45,000 hospital bill?August 27, 2012: 6:30 AM ET
A 61-year-old neighbor of mine in Oregon recently incurred a $45,000 hospital bill. She is unemployed and uninsured. The hospital gave her some financial assistance, but because she has some savings, including an IRA worth $220,000, the hospital argues that she has the resources to pay the balance. What should she do? Should she withdraw funds from her IRA, resort to a reverse mortgage or risk defaulting and being turned over to a collection agency? — L. Wilson
Your neighbor should negotiate the terms of a payment plan with the hospital, spreading the payments over as many years as possible to make them easier to fit into her budget. "Don't let this go to a collection agency," warns Anna Sergunina, with Mainstreet Financial Planning in San Mateo, Calif. "It's a lot easier to negotiate with the hospital than with the collection agency."
Your neighbor doesn't have many other options. If she drew on her IRA assets, she'd have to pay income tax on the withdrawal, which likely would add between $6,750 and $11,250 to her cost, depending on her tax bracket. A reverse mortgage is out: They are only for people age 62 or older. One possibility she could consider is a home equity line of credit. "Interest rates are low," says Sergunina. "But she might have difficulty qualifying because she's unemployed and has very little income."
If collection agencies do get involved, she should know that her Social Security benefits and IRA assets are safe. Social Security payments can't be garnished, except by the federal government, and in Oregon, IRA assets are protected from creditors (the rules vary from state to state).
— Austin Kilham
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