Financial Options for Covering Your Medical Costs in Texas

Resources for covering medical expenses and who to call if your medical bill hits the roof

In Texas, like anywhere, a car accident means stress and injuries, and often, big medical bills and loss of work time.

If the accident was major and you are in Texas’ claims or legal process now, you don’t have the money yet. So how should you pay your medical bills?

Your Texas attorney, if you have one, can help you to work through the medical bills so you can get treatment and still pay your mortgage and other bills.

They can point you toward some great resources in Texas that can be of assistance. Here are some you can reach out to, to find out if you qualify for financial help after your accident.

Use your health insurance

When you are badly hurt in an accident, obviously you need treatment immediately. If the accident is major, you could easily have thousands in hospital bills racked up in a week.

If you have health insurance, you should use it to pay your immediate medical bills as you get them. If the other driver is at fault, the bills will be paid back because the other insurance company must do so: Texas is an at-fault state.

While it may be tempting to wait for the other driver’s insurance to pay your bills, that payment would not occur until a settlement or judgment is final.

Using your health insurance ensures that your bills do not go to collections, because ruined credit is the last thing you need while dealing with major injuries and a totaled car.

Additionally, by using your own health insurance you might end up paying less. You won’t have to pay each health care provider back separately after settlement or judgment.

Health insurance companies have agreements with most medical providers to pay only partial fees. When the case is concluded, your health insurance company will request reimbursement. This is known as subrogation.

At-fault states require at-fault party to pay for damages

States are either a no-fault state or an at-fault state. Texas is an at-fault state. This means that the person that is at fault in the auto accident must compensate the injured person for the amount that he or she is liable for.

These payments usually come from the at-fault driver’s insurance company. Accident damages that are covered under Texas law include:

• Medical bills
• Lost wages
• Property damages

However, this doesn’t mean they will automatically cover your bills as they come in. Learn more about this and other myths surrounding personal injury/accident cases.

Each at-fault state has required minimum insurance coverage that each driver must maintain. In Texas, the current minimum liability limits are:

• $30,000 for each injured person
• Up to $60,000 per accident
• $25,000 for property damage per accident

Remember: This is the bare bones minimum. Depending upon how bad the accident is, personal and property damages could be much higher.

If your damages are worth much more than the other driver’s maximum coverage amounts, you can file suit to collect the difference.

Other options

Contingency-based medical billing

If you have bills that your health insurance won’t cover, your attorney may be able to provide access to doctors that will bill you on a contingency basis.

This means that the lawyer arranges for your medical bills to be delayed until a settlement is reached. The law firm would reimburse the doctor out of the settlement check.

If your attorney cannot make such arrangements for you, you could have to pay for your own medical care.

That huge hospital bill in the mail

Despite your best efforts, you still might open your mail and hit the floor: there’s a $9,000 hospital bill that you owe from your car accident. What should you do?

First, if you had a personal injury attorney on your case, you should call him or her immediately. Something could have fallen through the legal cracks with the billing.

Next, check these tips from the Texas Department of Insurance (TDI):

Call the doctor

Call your doctor or medical provider that sent the bill. Discuss the situation. The TDI website says that Texas law mandates that medical providers give you an itemized bill upon request. So check those charges carefully. The provider may negotiate on a payment structure.

Check average market prices

You can compare how much you were charged to average market prices. TDI has a Health Insurance Reimbursement Rates Consumer Information Guide that can help.

Consumer Help Line

TDI has a Consumer Help Line (1-800-252-3439) and can usually offer one of two things:

• Mediation: TDI can work with the health care provider on a payment plan. Texas law allows most consumers to seek mediation if a bill is more than $500. TDI says it has helped 94% of consumers lower their bill in this stage.
• Complaints: TDI helped Texas consumers save $490,518 in excessive medical bills in 2015.

File a complaint

If you think you received an unfair bill and still need help, you should file a complaint with the appropriate state regulator:

• Complaints against Texas physicians should go to the Texas Medical Board.
• Complaints against Texas hospitals or other facilities should go to the Texas Department of State Health Services.
• Complaints against HMOs and health insurance companies should go to the Texas Department of Insurance.

While facing large medical bills after an accident can be intimidating, we hope that some of the resources on this page have shown you that there is help available.

More information on getting medical bills paid after a personal injury:

• See the Law Dictionary’s article on getting the medical insurance company repaid after you receive a settlement.
• Nerdwallet.com has helpful information about how unpaid medical bills can lead to credit problems.

Additional health care coverage:

You may face ongoing health needs after an accident, particularly if you become permanently disabled. There are resources for people who do not have adequate health insurance coverage in that scenario:

• Texas Medicaid and the Child Health Insurance Program (CHIP) help cover medical expenses for children, families and people with disabilities who meet income requirements. Contact 1-800-925-9126 for more information.
•  Texans with disabilities may apply for benefits at their local Social Security Office (1-800-772-1213). Social Security forwards the applications to Texas Disability Determination Services (DDS) for a disability determination.
• Texas Health Resources is a faith-based, nonprofit health care system that maintains a policy to provide care for individuals in need of financial assistance. Patients who are unable to pay for some or all of their treatment may apply for financial assistance.

Other financial resources

While you are recovering from your injuries, there is a good chance you are missing time from work. While health insurance may cover your medical fees it won’t address your rent or mortgage, utilities, groceries or other basic necessities. But there are resources in Texas to assist you during these scary times.

The website NeedHelpPayingmyBills.com offers information on numerous government and private support services offered in the state, including county-specific information. Among those featured:

State government resources

• Rental assistance referrals are available from the Texas Health and Human Services Commission’s statewide database by calling 1-877-541-7905.
• Information on rental assistance is also available at the Texas Department of Housing and Community Affairs, including options for persons with disabilities.
• Foreclosure assistance counseling for homeowners is available from state HUD offices, which are listed here.
• The Texas SNAP Food Benefits Program helps people with lower income buy food for a limited time.
• Temporary Assistance for Needy Families (TANF) offers short-term grants to families below both resource and income limits set for the program. There is also a one-time TANF for families that are in a short-term crisis.
• The Texas Comprehensive Energy Assistance Program utilizes the federal Low Income Home Energy Assistance Program (LIHEAP) to help residents in need pay utility and air conditioning bills, and for energy conservation measures.

Private sector resources

• Community Action Agencies (CAAs): CAAs focus on providing services to the unemployed, working poor, low-income and the disadvantaged. Services may include career counseling, assistance with finding a job and services like budget and credit counseling. (Includes a contact list of CAAs across the state.)
• Salvation Army: The Salvation Army has dozens of locations around Texas that may be able to provide emergency assistance and funding to the low income families who qualify.
• Food Banks: Numerous nonprofits in the state provide produce, dairy products, holiday meals, meats, and more for families in need.
• Credit Counseling/Debt Consolidation: This is a list of organizations that deal with credit repair, debt management plans, bankruptcies and other financial issues.

The journey to recovery after an accident can be a long one filled with complicated legal processes and medical appointments. Accessing the proper support services can help your family deal with these logistical hassles so that you can focus on your recovery.