Even for those with health insurance, a visit to the hospital can be financially devastating.

According to a 2016 report by Kaiser Family Foundation, one in five insured working-age Americans reported having problems paying medical bills in the previous year that often cause serious financial challenges. According to another Kaiser study from 2017, 43% of adults with health insurance say they have difficulty affording their deductible, and roughly a third say they have trouble affording their premiums and other cost sharing.

Oftentimes when you come home from the hospital, another ordeal begins: the bills come, sometimes from different departments and different doctors.

The good (or bad) news is that you’re not alone. According to Consumer Financial Protection Bureau data, 43 million Americans owe medical debt. Making heads or tails of the medical bills can be even more intimidating than going to get a check-up in the first place.

Here are four ways to make your medical debt manageable. But before you read these tips: if you are having a medical emergency, seek treatment immediately. Don’t let the prospect of medical debt stop you from getting the help you need.

Negotiate your bill

All medical bills are negotiable. Emergency room bills, bloodwork bills, biopsy bills, X-ray bills, all of them. If you can, find out exactly what procedures you’re going to have done beforehand and research the average cost. Bruce McClary of the National Foundation for Credit Counseling suggests the Healthcare Blue Book.

Search for your procedure, test or doctor visit, find the average cost and then call the doctor’s office and ask what they charge. If they’re charging you below the average, you probably won’t have much wiggle room, but if they’re charging you more, ask them if they can bring the price down to a more reasonable range.

Don’t worry if you can’t do this before you get care. Life happens. You can negotiate after you’ve gotten the bill, but don’t put it off.

Set up a payment plan

If you get a huge hospital bill for tens of thousands of dollars, you might freak out wondering how you’ll ever pay it. Even if you have a hefty emergency fund, a $20,000-plus medical bill can shock you.

After you’ve negotiated your bill down — or at least tried to — ask your doctor’s billing office to set up a payment plan. Doctors’ offices know most people can’t handle big expenses at a moment’s notice and are usually willing to work with you.

“They want to get paid, obviously, but they also want to make sure that they’re doing something that’s affordable for you,” said McClary.