Astronomical medical bills are a financial land mine that can hit just about anyone, anytime.

It's true: Unexpected and expensive medical events disproportionately affect poorer Americans. But even the financially well-off can get torpedoed by these surprise bills, upending mortgages, retirement accounts, and other accumulated wealth.

That doesn't mean you should stop seeing your doctor lest you get an expensive diagnosis. Nor does that mean you shouldn't call 911 in fear of ambulance and hospital charges.

But it does mean you must be your own advocate—which, among other things, means looking out for red flags in your medical bills.

The Tea

How ubiquitous is the struggle of high medical bills?

Denzel took an ER hostage because he couldn't afford a $250,000 heart transplant for his son.

OK, OK, Denzel was just doing his usual masterful acting. Still: High medical costs and crippling medical debt are so pervasive that they have become regular premises of TV and movie shows.

Young and the Invested Tip: Health care costs will be a significant portion of your retirement budget. Here's what you need to know to determine how much you'll need to save.

A survey by health care nonprofit KFF found that 41% of adults have some form of debt caused by medical or dental bills, whether that was for their own care or someone else's.

The same survey reported that beyond the 41% above, another 16% said they've had medical or dental bills in the past five years that have since been paid off. "This means in total, most adults (57%) have experienced owing money due to medical or dental bills at some point in the past five years," KFF says.

More broadly? (Emphasis ours.)

"Nearly three-quarters of adults say they are worried about affording unexpected medical bills or the cost of health care services, higher than the shares who report worrying about affording other household expenses," KFF says.

And if you think this is just a concern for those unable to afford health insurance, think again.

A survey from Gallup and nonprofit collective West Health shows that more than 31 million Americans borrowed about $74 billion last year to pay for health care despite most having some form of health insurance.

Young and the Invested Tip: Do you plan on retiring before you qualify for Medicare? You should get familiar with your health insurance options.

And anecdotes from decades' worth of health-cost reporting shows that the damage goes beyond what we can see in debt surveys. In some cases, Americans do manage to avoid taking on debt to pay massive medical bills—but only by selling off their homes or emptying their 401(k)s.

In some cases, the bills simply are what they are. Maybe you're uninsured. Maybe you're insured, but you had an expensive procedure performed out-of-network and it simply isn't covered. For any number of reasons, an expensive bill might be on the up-and-up.

In some cases … but not all. Bills can indeed be wrong. And unlike in many other financial scenarios where a close eye can net you a few bucks in savings, catching issues on a medical bill could spare you thousands of dollars in undue costs.

The Tea

This week, we've been joined by Ted Kaplun, a Pennsylvania‑licensed personal injury attorney and founding partner of KaplunMarx, to talk about some red flags people should watch out for when reviewing their medical bills.

"Many patients don't realize they have strong legal protections under the federal No Surprises Act, which caps their in‑network cost share and bans balance‑billing for most emergency care or for out‑of‑network clinicians at an in‑network hospital," he says. "Billing errors and inflated charges are still common, so review every statement before paying and remember that asking for a price review is normal, not confrontational."

Among the most common issues to look for?

5 Red Flags on Medical Bills

1. Duplicate Charges

"This is the most common billing error, where patients are charged twice for the same service, test, or medication," Kaplun says. "These duplicate entries often appear on different pages of lengthy bills, making them easy to miss."

How to spot it: "Look for repeated line items, identical codes, or similar charges, especially in labs or imaging."

2. Upcoding

"This happens when a basic procedure is billed as a more complex and expensive one," he says.

How to spot it: "Request the specific CPT codes (five-digit numbers that identify procedures) for services and compare them with the actual care you received."

3. Phantom Services

"Surprisingly common are charges for services that you never received, including specialist consultations that never occurred and tests that were ordered but canceled or never performed," Kaplun says.

How to spot it: "Create your own care timeline and question anything unfamiliar or missing from your actual experience."

Young and the Invested Tip: Patients have numerous ways to negotiate a medical bill lower … including a few options even if that debt gets sent to collections.

4. Unbundled Charges

"Procedures are split into separate charges when they should be billed as a single service," he says. "This is particularly common with surgeries, labor and delivery, and comprehensive diagnostic testing."

How to spot it: "Look for multiple entries for what seemed like one procedure."

5. Incorrect Patient Information

"Simple typos or errors can lead to insurance claim denials, leaving you with the entire bill," Kaplun says. "A single incorrect digit in a patient's insurance ID or a misspelled name can result in complete claim denials, with the patient initially held responsible for tens of thousands of dollars."

How to spot it: "Check every detail: name, policy number, and dates of service must be 100% accurate."

One last thing to keep in mind? In many worst-case medical-billing stories, you'll hear stories about people fighting with hospitals and other providers for months, if not years, over charges. While this kind of drawn-out fight does happen, it shouldn't be your base-case assumption, so don't let your fears dissuade you.

"It only takes 15 minutes to catch errors that could save you thousands of dollars with a single phone call to the billing department," Kaplun says. "Most billing errors can be corrected simply by pointing them out, but only if you spot them early and reach out."

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Thank you for spending a little time with us yet again. We'll see you next week!

Riley & Kyle

Young and the Invested

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