SOUTH BEND — Do you understand your medical bills? Do you know what you're being charged for, or how billing works? What if you're among the thousands of Americans with an outstanding bill you just can't pay?

There are some options.

Carolyn Jackson says she didn't know what was going on when she received notice of a judgment against her.

"I'm on disability," she told WSBT News. "My husband gets a small Social Security check and that's our income.”

Jackson worked at Memorial Hospital for 23 years, but stopped after battling kidney cancer. She believes her insurance covered that, and assumes the judgement is from her husband's battle with prostate cancer.

"The options at that point in time, if she already has a judgment against her, are pretty limited," said Jeffrey Fulmer.

Fulmer is the director of patient accounts and admitting at Elkhart General Hospital. He says the first thing everyone should do is understand what their insurance does and does not cover.

"Too many people, they pay their premium out of their paycheck and they get a little card that says they're covered, but they don't go any further to really learn and understand it," he said.

Understanding your bill is another matter. Because of the cost, most hospitals don't send itemized bills. You have to request one, like Jackson did. As for the cost of a procedure or medication? — they vary from city to city, hospital to hospital.

That's right. There's no set rate for an MRI or CAT scan. Every hospital sets its own price. So questioning cost is tough. Hospitals employ some doctors, but most physicians are independent contractors. That means they too can charge whatever they want.