Getting hit with a medical bill you thought your insurance would pay is an all-too-common situation. There are two ways to combat surprise medical bills, whether they come from an emergency situation or from a healthcare professional: Prevent them in the first place or fight them later. Here’s our advice.

1. Prevent the Bills

Most surprise medical bills are the result of being treated by someone outside your insurance company’s network of providers. So you want to avoid those out-of-network providers whenever you can.

That’s easier in nonemergencies, such as when planning a knee replacement or having a baby. In those cases, ask the person who handles billing in your doctor’s office for a list of everyone who could conceivably be part of your care—such as the anesthesiologist and radiologist—including while you’re in the hospital.

Then call your insurer to make sure that those people are in your network. (Don’t rely on online directories; they can be out of date.) If anyone isn’t, tell the physician that you want only in-network providers. It’s harder to find them during an emergency because you might not have the time.

Still, it’s wise—before you need to go to an ER—to find out which nearby hospitals are in your network and use in-network ER physicians. Then, in an emergency, try to go to one of those if you can.

If you need an ambulance, you can ask to be taken to an in-network hospital, though the first responder onboard will make the final decision. So reserve ERs for true emergen­cies, and if it’s safe, go in a car.



2. Fight the Bills

If you’re stuck with a surprise medical bill, call the provider and your insurer. Explain that you didn’t realize the care, which was essential, would involve out-of-network providers.

Some physicians may accept the insurance payment and forgive the balance. Or the insurer and the out-of-network physician may agree to lower the bill, making it easier for you to afford.

If you’re billed for emergency care or ambulance transport, also ask the first responders or ER doctors to provide documents confirming that you had no choice in how you were transported and that it was medically necessary.

If all else fails, complain to your state’s health insurance agency, says Caitlin Donovan of the National Patient Advocate Foundation.

Those agencies can’t always help—for example, states have little power over air ambulances—but lodging a complaint could strengthen your bargaining power.

To find out where to file a complaint in your state, use Consumer Reports’ surprise medical bill tool.

The Patient Advocate Foundation also has counselors who can help. Contact them at patientadvocate.org or 800-532-5274.

Editor's Note: This article also appeared in the May 2017 issue of Consumer Reports magazine.