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Balance Billing Toolkit for Advocates

Recently, Justice in Aging released a toolkit of five model letters that advocates can use when their low income clients face illegal balance billing for Medicare co-pays, co-insurance or, deductibles.  Accompanying the letters is a webinar that explains balance billing protections for dual eligibles (people with both Medicare and Medicaid) and for people who are Qualified Medicare Beneficiaries (QMBs). The webinar and slide deck walk advocates through the basics of balance billing and the federal protections for beneficiaries. They provide examples of how the problem comes up and how to get it fixed. The toolkit gives advocates some simple letters that they can use as they work with providers to prevent erroneous bills.

Access all the materials here. The webinars, toolkit, and other materials are broken out in tabbed sections.

Balance billing occurs when doctors, hospitals, or other providers charge beneficiaries with both Medicaid and Medicare for Medicare co-pays, co-insurance, or deductibles. Balance Billing is illegal under federal law, yet it is a common practice as some providers are confused about their obligations under the law.

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