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Life Kit: How to Lower Your Medical Bills

Practical Strategies for Negotiating Medical Debt and Accessing Charity Care

Marielle Segarra (with guest Jared Walker, Founder of Dollar For)

NPR Life Kit (2025)

Key Takeaways

  • Look for “Charity Care” First. Non-profit (and many for-profit) hospitals must offer free-or-reduced care when your household income falls below their threshold—often up to 300 % of the U.S. poverty guideline.
  • Request an Itemized Bill. Ask for CPT codes and double-check that every test or procedure actually happened; billing errors are common and disputable.
  • The Numbers Are Negotiable. Call the billing office and ask for the settlement amount before revealing what you can pay. Calling back on another day—or asking for a supervisor—often yields a better discount (30–50 % is typical).
  • Use Advocates and Protect Your Bandwidth. Friends or family can make calls, track paperwork, and follow up, sparing you the cognitive load and stress that can amplify FND symptoms.

The Essentials

Medical debt is the leading source of personal debt in the United States, and people living with Functional Neurological Disorder frequently face repeated diagnostic tests, specialist visits, and hospitalizations. When finances tighten, stress hormones rise, sleep suffers, and FND symptoms often spike—creating a vicious cycle.

This Life Kit episode demystifies the U.S. medical-billing maze. Host Marielle Segarra and patient-advocate Jared Walker explain how charity-care laws, billing-error checks, and straightforward negotiation can slash bills—often to zero—without harming your credit. Their step-by-step scripts (“What’s the settlement amount if I close the account today?”) turn an overwhelming process into an actionable checklist you—or a trusted supporter—can follow.

For the FND community, these tactics translate directly into reduced financial strain and calmer nervous-system states, freeing up energy for symptom management and recovery rather than bill anxiety.

Why This Matters for FND

Money worries activate the body’s threat response, which can exacerbate functional symptoms such as tremors, seizures, or cognitive fog. By lowering or eliminating surprise bills, you lower that physiological stress load. The strategies highlighted require short, focused bursts of effort (or delegation), making them feasible even on low-energy days.

Resource Qualities

Applicability:

Accessibility:

Evidence-Based:

Practical Value:

Practical Applications

For Individuals with FND

Low-Energy Days

Building Long-Term Wellness

  • Create a dedicated folder (digital or paper) for itemized bills, CPT codes, and charity-care forms so future negotiations are one email away.

For Individuals with FND

Supporting Your Loved One

  • Offer to handle phone calls or draft the charity-care application; use the caller’s name and take notes each time to keep momentum.

Caring for Yourself

  • Set a specific call window (e.g., 30 minutes) and step away afterward—protecting your own nervous system from burn-out.

When This is Most Helpful

  • Soon after diagnosis when first hospital bills arrive.
  • During high-expense treatment phases (e.g., inpatient rehab, imaging).
  • Whenever a bill goes to “due upon receipt” status—you still have weeks to act before collections.

This summary is provided for informational purposes only and does not constitute medical, financial, or legal advice. It is not intended to replace professional consultation or treatment. Always consult qualified providers regarding your specific circumstances, symptoms, or questions.

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