How to deal with medical debt you can't pay

Before you pay a big medical bill, get an itemized bill, check it against your insurance statement and ask the hospital about financial assistance. Many medical bills can be lowered, and nonprofit hospitals must give you time to apply for help before they report you to the credit bureaus or sue.

Errors are common

Duplicate charges, services you didn't get, the wrong billing code and claims your insurer never processed all show up on medical bills. An itemized bill and your explanation of benefits are how you find them.

Hospitals must wait before collections

Nonprofit hospitals can't report you to credit bureaus, sell your debt or sue you until at least 120 days after the first bill, and they must give you 30 days' written notice before those actions.

There is no federal ban on medical debt in credit reports

A CFPB rule that would have removed most medical bills from credit reports was struck down by a federal court in July 2025 and never took effect. The credit bureaus' own limits still apply.

Surprise bills have limits

The No Surprises Act protects insured patients from most surprise out-of-network bills for emergency care and at in-network hospitals. Uninsured patients can get a good faith estimate and dispute a bill that runs $400 or more over it.

Step 1 is to make sure the bill is right

Call the billing office and ask for an itemized bill with billing codes. Then pull up your insurer's explanation of benefits for the same date of service. Check that the dates, services and amounts match, and that the insurer actually processed the claim.

If something looks wrong, ask the provider to correct it, and ask the insurer to reprocess the claim if it was denied for a fixable reason, like a missing code. Ask the provider to put the account on hold while you sort it out, and write down who you spoke to.

Step 2 is to ask for financial assistance

Every nonprofit hospital must have a written financial assistance policy for emergency and medically necessary care. Many people with moderate incomes qualify for a discount, not only people with very low income. Some for-profit hospitals and clinics have programs too.

Ask for the application, fill it out and send proof of income. You have at least 240 days from the first bill after discharge to apply. If you qualify, the hospital can't charge you more than it generally bills insured patients for the same care, and it must refund anything you overpaid.

Step 3 is to negotiate and set up a plan

If you don't qualify for aid, ask for a discount anyway. Some providers offer one for paying in full or for paying without insurance. Then ask for an interest-free payment plan sized to your budget.

Pay the provider directly rather than charging the bill to a credit card or taking a personal loan. A medical bill on a no-interest plan costs nothing extra. The same bill on a card at 24% can cost hundreds more.

What medical debt does to your credit

The three nationwide credit bureaus don't report medical collections that have been paid or that are under $500. Unpaid medical debt over $500 can appear only after it has been past due for a year from the date of service.

A federal rule that would have removed medical debt from credit reports was finalized in January 2025, but a federal court in Texas vacated it in July 2025, so it never took effect. More than a dozen states have passed their own limits, and lawsuits are testing whether federal law overrides them. Check your state attorney general's website for your state's rules.

If the bill goes to collections

A medical debt sold or sent to a collection agency is covered by the same federal debt collection rules as any other debt. You get a validation notice and 30 days to dispute in writing.

You can still ask the original hospital for financial assistance, and a nonprofit hospital is responsible for collection actions taken for it. If a paid or under-$500 medical collection shows up on your credit report, dispute it with the credit bureau.