Illinois Hospital & Medical Bill Laws (Statute of Limitations)

Illinois medical bill assistance programs, provider billing laws, and the statute of limitations help many patients with their finances.

However, if your household income exceeds the federal poverty level, or you do not fit into a protected class, you could wind up owing a tidy sum of money.

It will be challenging to make the problem go away.

Follow this three-part outline for possible avenues of help in dealing with the unpaid hospital, doctor, and dental bills.

  • Disclaimer – the following does not constitute legal or professional advice
  • Consult an attorney licensed in Illinois
  • Follow the footnoted links for the precise statutory language

Illinois Statute of Limitations

The Illinois statute of limitations time bars parties from filing lawsuits to recover debts or damages. In other words, the courts impose deadlines for when plaintiffs must file cases.

However, the SOL does not make your problems go away just because the indicated timeframe has come and gone.

Medical Debt

The Statute of Limitations (SOL) on unpaid medical bills in Illinois does not always work the way consumers hope. The length of time could be 5 or 10 years, and the start time can reset. Besides, the law does not stop creditors from collecting on the debt.

Pursue Debt

The statute of limitations on medical debt provides patients a legal defense against lawsuits by collection agencies or hospitals. However, the agency can win a lawsuit after the SOL expires if the debtor fails to appear in court and assert this defense.

Also, the law does not prevent collection agencies from pursuing the debt. You still owe the money, and the history can appear on your consumer credit report.

5 or 10 Years

The Illinois statute of limitations is 5 years for oral contracts and 10 years for written agreements. Medical debt could fall into either category.

Dentists, doctors, and hospitals frequently require a signed patient financial responsibility agreement before providing services. The existence of such a document and the specific terms contained in it dictate whether the contract is oral or written.

Consult an attorney when in doubt.

Start Date

The statute of limitations clock on unpaid medical bills starts ticking on the date of the last activity. The day of the last activity could be the treatment date; the last day the individual made payment or the last day the person acknowledged responsibility.

The multiple start date definitions mean that a person who makes a payment or acknowledges the obligation can reset the limitation years after treatment. Be careful.

Malpractice

The Illinois Statute of Limitations for medical malpractice and personal injury lawsuits is a consideration for patients who need money to pay physician, dentist, registered nurse, or hospital bills, along with compensation for pain and suffering, etc.

The SOL for medical malpractice and personal injury has three possible lengths, as defined by the Civil Procedure Code.[3]

  1. 2 years after the claimant knew about the injury or death
  2. 4 years after the act or omission occurred (statute of repose)
  3. 8 years after the act or failure for a minor under the age of 18

Therefore, act right away if you believe that a provider contributed to an unwanted outcome through negligence or another reason.

Illinois Medical Bill Assistance Programs

The State of Illinois provides two government-sponsored forms of financial assistance with an unpaid medical bill that helps mostly low-income residents and the uninsured. The rest of us who earn money through hard work and pay expensive health insurance premiums must fend for ourselves.

Debt Relief

Do you qualify for debt relief? A consolidation program is a viable option for patients struggling with a mountain of unpayable medical bills and other unsecured obligations. The eligibility criteria are viable for many people to meet.

  • Have an ongoing income and steady employment
  • Owe more than $10,000 in unsecured debt
  • Suffering financial hardship (behind on payments to creditors)

The debt relief company will consolidate all of your payments and hold the money in an escrow account. Once the escrow balance reaches about 30% of your obligations, the company will attempt to negotiate a settlement that could reduce what you owe substantially.

Charity Care

The Illinois Hospital Uninsured Patient Discount Act mandates charity care for low-income families that must pay for services 100% out-of-pocket. Often, they do not have healthcare coverage.

This legally required charity care forces hospitals to reduce charges for patients meeting specific eligibility criteria. The state law stipulates the discount calculations and crucial other definitions.[1]

An uninsured person is someone without third-party coverage

  • High deductible plans count as coverage
  • Consumers must apply for the discount within 60 days of discharge
  • The hospital cannot collect more than 25% of the patient’s annual gross family income
  • Charges cannot exceed 135% of the cost of services
  • The person must be a resident of Illinois
  • Patients must meet family income and asset limits
    • 300% of the poverty level for urban centers
    • 600% of the poverty level for rural and critical access centers

Medicaid

The Illinois Medical Bill Assistance policy includes the federal Medicaid program, which provides health insurance coverage to low-income families. Many applicants can obtain coverage three months retroactively.

Applicants must fit into one of these three protected class categories, along with meeting income guidelines based on the federal poverty level.[2]

  • Blind, disabled, age 65 or older
  • Have children under the age of 19
  • Pregnant women

Other protected classes of residents can apply for specialized medical assistance benefits.

The Illinois Medical Card benefits include most medically necessary procedures across all programs. Other covered services have more complex rules and requirements.

  • Dental care
  • Prescription drug coverage
  • Eyeglasses and vision care

Family Leave

Illinois family medical leave laws provide 12 weeks of unpaid job and health insurance protections, which come in handy during the immediate aftermath of a severe accident or illness. However, only about half of workers qualify for this valuable benefit.

  • Covered employers have 50 or more employees working within a 75-mile radius
  • Eligible employees work for a covered employer
    • 12 months of consecutive service
    • 1,200 hours worked in the last 12 months

Other Illinois Medical Bill Laws

Illinois medical bill laws provide patients with a variety of legal rights. Rather than list the regulations in dense legalize, we chose to answer the three most common questions people have.

  1. Am I responsible for my deceased spouse’s debts?
  2. How long does the hospital have to send a bill?
  3. Should I pay surprise balance bills from out of network doctors?

Spousal Responsibility

The Family Expenses Act (750 ILCS 65/154) addresses the question of whether a spouse is responsible for medical bills after death in Illinois. The act makes a person liable for the expenses of the family, which includes the husband, wife, and dependent children.[4]

The law defines medical debt and funeral charges as a family expense. Therefore, the surviving single spouse is responsible for hospital bills incurred by the deceased husband or wife.

Hospital Charges

The Fair Patient Billing Act does not appear to provide a direct answer to the question of how long a hospital has to bill you in Illinois.[5] Therefore, expect that you are responsible for payment regardless of how much time elapses between discharge and the final receipt of the invoice.

Hospitals frequently delay sending out bills to patients while they process claims with the health insurance company. Log into your insurance company’s web portal and check the Explanation of Benefits (EOB) for each date of service. The EOB can often provide an early estimate of your out-of-pocket costs.

  • Deductible
  • Co-insurance
  • Copayments
  • Out-of-network fees

Surprise Bills

The Balance Billing Act protects Illinois patients from surprise medical bills from out-of-network providers.[6] You no longer have to worry about checking into an in-network hospital and then later receiving an unexpected invoice from an anesthesiologist, pathologist, radiologist, or neonatologist that does not participate in your plan.

Under the balance billing law, the health insurance plan must ensure that the patient does not incur higher out-of-pocket costs than he or she would have incurred with a participating provider.

Sources:

[1] (210 ILCS 89/) Hospital Uninsured Patient Discount Act.

[2] IL Department of Human Services Medical Assistance

[3] (735 ILCS 5/) Code of Civil Procedure

[4] Querry & Harrow Family Expense Act

[5] (210 ILCS 88/) Fair Patient Billing Act

[6] (215 ILCS 5/356z.3a) Compiled Statutes