Boy from Texas second dose of MMRV vaccine cost over $1400. Pennsylvania Woman long-acting contraceptives cost over $14,000.
Medicaid Treatment in Florida acute cardiovascular disease cost nearly $78,000—about the same as the surgery on an uninsured Montana woman. broken arm.
In 2025, these patients were among hundreds who asked KFF Health News investigate their medical bills as part of their “Bill of the month” row.
Insured and uninsured. Based on jobs and government funding. Comprehensive and short-term. Part of the sharing ministry. So many people with different health insurance situations have asked the same questions: Why do I owe so much? And how can I afford it?
As millions of Americans grapple with rising health insurance costs over the next year, the Count of the Month series is approaching its eighth anniversary. Our nationwide team of medical reporters has analyzed nearly $7 million in medical expenses, more than $350,000 of it this year.
Of the 12 patients represented this year, five had their bills mostly or completely forgiven shortly after we contacted the provider and insurance company for comment.
Our mission, however, is to provide every patient with the information necessary to understand, manage and—if it comes down to it—fight their own medical bills. Here are our 10 takeaways from 2025.
1. In most cases, coverage does not begin immediately. Many new plans come with waiting periodstherefore, it is important to maintain continued coverage until the new plan goes into effect. The only exception is that if you lose your coverage through your job, you have 60 days to opt in. COBRA policy. Once you pay, coverage is applied retroactively, even for care received while you were temporarily uninsured.
2. Check your insurance coverage before signing up. Some plans have unexpected restrictions that potentially affect coverage of health care services ranging from contraception to immunizations and cancer screening. Call your insurer—or, in the case of employment-based insurance, your human resources or retiree benefits department—and ask if there are exclusions for the care you need, including limits per day or per policy period, and what you can expect to pay out of pocket.
3. “Coverage” does not mean the insurance will pay, let alone in-network rates. Read the fine print carefully about network break exclusions, pre-authorizations, and other insurance allowances. Terms may be limited specific doctors, services and dates.
4. Get a written cost estimate for non-emergency procedures. If you mind the price, negotiate before treatment. And if you're uninsured and receive a bill for $400 or more than expected, the federal Centers for Medicare and Medicaid Services has formal dispute process.
5. Location matters. Prices may vary depending on where the patient receives care and where the tests are performed. If you need a blood test, ask your doctor to send your request to an in-network laboratory. Doctor's office connected to the healthcare systemfor example, may send samples to a hospital laboratory, which may mean higher costs.
6. Upon admission, contact the billing office in advance. If possible, when you or a loved one has been hospitalized, it can be helpful to speak with a billing representative. Ask whether the patient was fully hospitalized or under observation, and whether care was provided. deemed “medically necessary.” And although there may be no choice ride in an ambulanceIf transfer to another institution It is recommended that you find out if there is an ambulance service online.
7. Ask for a discount. Medical costs are almost always higher than what insurers would pay because providers are expected to negotiate lower rates. You can too. If you are uninsured or underinsured, you may be entitled to discount for self-payment or charitable donation.
8. Help is available for Medicaid patients. If you receive an invoice, you I don't think you shouldfile a complaint with your state's Medicaid program and, if you have one, with your managed care plan. Ask if you have a social worker who can advocate on your behalf. A legal aid clinic or consumer defense firm that specializes in medical debt can also help file a complaint and contact service providers.
9. Your elected representatives can help too. While a call from a state or federal legislator's office may not result in your bill being forgiven, these officials will often open line of communication with insurance companies, local hospitals and other major service providers, and it is their job to protect you.
10. When all else fails… you can write to the “Poster of the month”!
Most insurances cover IUDs. Its cost exceeds $14,000.
Julie Appleby
January 31, 2025
The Affordable Care Act requires most insurance plans to cover preventive care, including many forms of contraception, at no cost to patients, but not if they are “legacy” plans that predate the law.
A jogger gets hit by a car and then an unexpected ambulance bill.
Sandy West
February 28, 2025
A San Francisco man asked friends to take him to the hospital after he was hit by a car. Doctors examined him, then sent him by ambulance to a trauma center, where he was released without further treatment. Ambulance bill? Almost $13,000.
He had short-term health insurance. His colonoscopy bill: $7,000.
Julie Appleby
March 28, 2025
After quitting his job to start 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 that his plan's limited benefits would cost him dearly.
The patient was expecting a free examination. The bill was $1,430.
Samantha Liss and Lauren Sausser
April 30, 2025
Carmen Aiken of Chicago thought their doctor's visit would be covered because the Affordable Care Act requires insurers to pay for a long list of preventive services. But after his appointment, Aiken received a bill for more than $1,400.
A Medicaid patient had a heart attack while traveling. He owes nearly $78,000.
Ariel Zionts,
May 29, 2025
Federal law states that Medicaid must cover out-of-state emergency care. But a Florida man received a five-figure bill after a South Dakota hospital refused to charge his state's Medicaid program.
A Texas boy needed protection from measles. The vaccine cost $1,400.
Julie Appleby
June 30, 2025
A Galveston family was surprised to learn they were charged thousands of dollars for their children's vaccinations. Their insurance plan did not cover vaccinations, and the cost of the measles vaccine in particular was more than five times the cost of the vaccine in the private sector, according to health officials.
A tourist ended up with a wild bat in her mouth – and nearly $21,000 in medical bills.
Tony Lace
July 31, 2025
Medical insurance generally does not cover treatment for injuries sustained shortly before the client purchases the policy. A woman from Massachusetts learned this the hard way.
The insurance company agreed to cover her surgery. Thanks to the politician's nudge, the bills were paid.
Kara Anthony
August 26, 2025
A Missouri kindergartener required eye surgery. Her insurance company allowed her to see a specialist nearby, but 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 insurance company.
She had a broken arm, no insurance and a $97,000 bill.
Katherine Houghton
September 24, 2025
Deborah Butgereit knew that repairing a broken bone in her elbow would be expensive. But complications the doctor deemed unexpected midway through the operation sent the total bill tens of thousands of dollars higher than the original estimate.
Doctor lost $64,000 bill for ankle surgery and hospital stay
Julie Appleby
October 29, 2025
A Colorado doctor became a patient after an accident wrecked her car and sent her to the operating room. She was kept in the hospital overnight, but her insurance company stopped paying after she left the emergency room.
Not serious enough to set off the siren, a 39-mile ambulance ride for a toddler still costs more than $9,000.
Tony Lace
November 25, 2025
After her son contracted a serious bacterial infection, an Ohio mother took the toddler to a nearby emergency room and staff there rushed him to a children's hospital by ambulance. Without insurance, the family had to pay $9,250 for the 40-minute trip.
The scorpion peppers caused him “crippling” pain. Two years later, the EMS bill bit him again.
Elizabeth Rosenthal
December 19, 2025
Homemade hot sauce sent a Colorado man to the emergency room with what he called “the worst pain of my life.” But the stomach cramps were just the beginning. Two years later the bill arrived.
Photographers
Jason Ardant, Scott Dalton, Lauren Elliott, Jamie Kelter Davis, Matt Kyle, Jacob Langston
Maddie McGarveyParker Michels-BoyceSophie ParkJim WondruskaJeremy Wade ShockleyRachel Wolfe
“Bulletin of the Month” – a crowdsourced investigation conducted by KFF health news And Prosperity Washington Post who analyzes and explains medical bills. Since 2018, the series has helped many patients and readers reduce their medical bills and has been cited in statehouses, the U.S. Capitol, and the White House. Do you have a confusing or outrageous medical bill you want to share? Tell us about it!
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