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A Texas boy’s cost over $1,400. A Pennsylvania woman’s cost more than $14,000.
Treatment for a Florida Medicaid enrollee’s cost nearly $78,000 — about as much as surgery for an uninsured Montana woman’s .
In 2025, these patients were among the hundreds who to investigate their medical bills as part of its “” series.
Insured and uninsured. Job-based and government-funded. Comprehensive and short-term. Part of a sharing ministry. So many people with different health insurance situations asked the same questions: Why do I owe so much? And how am I going to afford it?
As millions of Americans grapple with the rising cost of health insurance next year, the “Bill of the Month” series is approaching its eighth anniversary. Our nationwide team of health reporters has analyzed almost $7 million in medical charges, more than $350,000 of that this year.
Of this year’s 12 featured patients, five had their bills mostly or fully forgiven soon after we contacted the provider and insurer for comment.
Our mission, though, is to empower every patient with the information needed to understand, manage, and — if push comes to shove — fight their own medical bills. Here are our 10 takeaways from 2025.
1. Most insurance coverage doesn’t start immediately. Many new plans , so it’s important to maintain continuous coverage until the new plan kicks in. One exception: If you lose your job-based coverage, you have 60 days to opt into . Once you pay, the coverage applies retroactively, even for care received while you were temporarily uninsured.
2. Check out your coverage before you check in. Some plans come with unexpected restrictions, potentially affecting coverage for care ranging from contraception to immunizations and . Call your insurer — or, for job-based insurance, your human resources department or retiree benefits office — and ask whether there are exclusions for the care you need, including per-day or per-policy-period caps, and what you can expect to owe out-of-pocket.
3. “Covered” does not mean insurance will pay, let alone at in-network rates. Carefully read the fine print on network gap exceptions, prior authorizations, and other insurance approvals. The terms to certain doctors, services, and dates.
4. Get a cost estimate in writing for nonemergency procedures. If you object to the price, . And if you’re uninsured and receive a bill that’s $400 or more than the estimate, the federal Centers for Medicare & Medicaid Services has a .
5. Location matters. Prices can vary depending on where a patient receives care and where tests are performed. If you need blood work, ask your doctor to send the requisition to an in-network lab. A doctor’s office , for instance, may send samples to a hospital lab, which can mean higher charges.
6. When admitted, contact the billing office early. If possible, when you or a loved one has been hospitalized, it can help to speak to a billing representative. Ask whether the patient has been fully admitted or is being kept under observation status, as well as whether the care has been And while there may be no choice about , if a is recommended, you can ask whether the ambulance service is in-network.
7. Ask for a discount. Medical charges are almost always higher than what insurers would pay, because providers expect them to negotiate lower rates. You can, too. If you’re uninsured or underinsured, you may be eligible for a .
8. There’s help available for Medicaid patients. If you get a bill you , file a complaint with your state’s Medicaid program and, if you have one, your managed-care plan. Ask whether there is a caseworker who can advocate on your behalf. A legal aid clinic or consumer protection firm specializing in medical debt can also help file complaints and communicate with providers.
9. Your elected representatives can help, too. While a call from a state or federal lawmaker’s office may not get your bill forgiven, those officials often have with insurance companies, local hospitals, and other major providers — and advocating for you is their job.
10. When all else fails … you can !
The Affordable Care Act requires most insurance plans to cover preventive care, including many forms of contraception, without cost to patients — but not if they’re “grandfathered” plans, which predate the law.
A San Francisco man had friends drive him to the hospital after he was hit by a car. Doctors checked him out, then sent him by ambulance to a trauma center — which released him with no further treatment. The ambulance bill? Almost $13,000.
After leaving his job to launch his own business, an Illinois man opted for a six-month health insurance plan. When he needed a colonoscopy, he thought it would cover most of the bill. Then he learned his plan’s limited benefits would cost him plenty.
Carmen Aiken of Chicago thought their medical appointment would be covered because the Affordable Care Act requires insurers to pay for a long list of preventive services. But after the appointment, Aiken received a bill for more than $1,400.
Federal law says Medicaid must cover out-of-state emergency care. But a Florida man got a five-figure bill after a South Dakota hospital declined to charge his state’s Medicaid program.
A family living in Galveston was surprised to be charged thousands of dollars for immunizations for their children. Their insurance plan didn’t cover the shots, and the cost of the measles vaccine in particular was more than five times what health officials say it goes for in the private sector.
Health insurance generally doesn’t cover treatment for injuries sustained shortly before a customer buys a policy. A Massachusetts woman found that out the hard way.
A kindergartner in Missouri needed eye surgery. Her insurer granted approval for her to see a specialist nearby, yet her parents were confused when they still owed more than $13,000. Then her uncle, a former state senator, reached out to a colleague who contacted the hospital and the insurer.
Deborah Buttgereit knew piecing together the broken bone in her elbow would be expensive. But complications the doctor deemed a surprise, midsurgery, drove the total bill tens of thousands of dollars above the original estimate.
A doctor in Colorado became the patient after an accident totaled her car and sent her to the operating room. The hospital kept her overnight, but her insurer stopped paying after she left the emergency room.
After her son contracted a serious bacterial infection, an Ohio mother took the toddler to a nearby ER, and staffers there sent him to a children’s hospital in an ambulance. With no insurance, the family was hit with a $9,250 bill for the 40-minute ride.
Homemade hot sauce sent a Colorado man to the emergency room with what he called “the worst pain of my life.” But stomach cramps were only the beginning. Two years later, the bill came.
Jason Ardan
Scott Dalton
Loren Elliott
Jamie Kelter Davis
Matt Kile
Jacob Langston
Maddie McGarvey
Parker Michels-Boyce
Sophie Park
Jim Vondruska
Jeremy Wade Shockley
Rachel Woolf
Bill of the Month is a crowdsourced investigation by and that dissects and explains medical bills. Since 2018, this series has helped many patients and readers get their medical bills reduced, and it has been cited in statehouses, at the U.S. Capitol, and at the White House. Do you have a confusing or outrageous medical bill you want to share? !
