If you're uninsured and unable to pay you may be able to get the Medicare rate as a "I will pay you this amount to settle this in full, and I will pay it today"

If you're uninsured and unable to pay you may be able to get the Medicare rate as a "I will pay you this amount to settle this in full, and I will pay it today" because that rate is still higher than they'd get from selling it to collections.