Medical Bills: What To Do if You Can’t Pay

By Upstart Content Team | Updated December 10, 2022
reading time 6 min read
Older man looking at medical bills with a laptop

Key takeaways: 

  • 9% of Americans carry at least $250 in medical debt.
  • Unpaid medical bills may go to collections, which can impact your credit score.
  • Negotiating a settlement, requesting hardship assistance, or financing medical debt can help you better manage your healthcare expenses.

Medical bills are often an unavoidable part of life. However, they can quickly become overwhelming, leaving patients wondering how to pay bills instead of recovering. In fact, a Kaiser Family Foundation study found that nearly 1 in every 10 American adults owe medical debt—that’s about 23 million people.

But what happens if you can’t afford your medical bills? Below, we’ll take a look at some of the outcomes of unpaid medical bills. We’ll also discuss ways to manage healthcare costs.

What happens if you don’t pay medical bills?

Like most forms of debt, medical bills don’t go away if you ignore them. Also, leaving medical debt unpaid can have serious consequences.

We’ll provide more information on how to manage your unpaid medical bills shortly. But first, let’s take a look at some of the consequences of not paying your medical bills:

  • Your healthcare provider may sell your debt to a collections agency. If you’re unable to repay your medical bills, your hospital or healthcare provider could sell your debt to a collections agency. The agency will then work to collect on your unpaid bills.
  • You could be sued for medical bills. If a debt collections agency or hospital can’t collect their debt, they may be able to file a lawsuit. Court cases are often expensive and add additional stress to the emotional and financial burden of unpaid debt.
  • Your credit score may be impacted. Debt collection agencies may report medical debt to the three major credit bureaus: Equifax®, Experian™, and TransUnion®. Medical debt over $250 won’t appear on your credit report for 12 months. But after the grace period ends, unpaid medical bills in collections may cause your credit score to drop by as much as 100 points.
  • Your wages could be garnished. In some cases, a debt collection agency or hospital can garnish your wages if they’re unable to collect on your debt. When you have your wages garnished, a portion of your paycheck is withheld and sent to your creditor until you’ve repaid the balance in full.

What to do if you can’t afford your medical bills

If medical bills are piling up and you’re struggling to cover the costs, consider the following 4 tips for managing healthcare expenses.

1. Review your bills

An American Medical Association study estimated about 7% of medical bills contain errors, though the number may be higher. Some of the most common mistakes found on medical bills include: 

  • Duplicate charges
  • Charges for services you didn’t receive or don’t recognize
  • Charges for services that should have been covered by your health insurance company

With that in mind, it’s a good idea to review the services and charges listed on your bills before making a payment. 

Ask for an itemized bill if you don’t have one. Check the itemized statement for the services you received and flag any charges you don’t recognize. You can also compare charges you’re responsible for against the ones your insurance company should pay. For a closer look at your out-of-pocket costs, request an explanation of benefits (EOB) statement from your insurance company.

How to dispute a medical bill if you find a mistake

If you think there’s an error on your bill, call your healthcare provider and ask for clarification. You can also ask them to walk through each charge with you and correct any errors in real time. If you identify a charge that should be covered by your health insurance plan instead, reach out to your insurer to file an appeal.

Most importantly, address any billing errors as quickly as possible. You generally have a window of 30–60 days from the date you received your bill to file an appeal or make a payment. Some insurance companies only give you a certain period of time to appeal a coverage decision as well.

2. Negotiate a settlement

Reach out to your hospital’s medical billing manager to negotiate your bill. You may qualify for a settlement if you prove that paying your debt in full will be difficult or impossible.

You may also consider asking for hardship assistance. Hardship assistance and hospital charity care programs may be available for qualifying patients. For more information, contact your providers.

Pro tip: Under the Affordable Care Act, certain nonprofit hospitals are required to provide low-income or uninsured patients with financial assistance for medical bills. If you’re approved for assistance, you may receive a partial or full reduction. Ask your healthcare provider for additional information and to see if you qualify for aid.

How to negotiate medical bills

Negotiating your medical bill can seem intimidating, but hospital billing departments are used to working with patients. However, this doesn’t mean your hospital will reduce your bill automatically. 

Instead, do some research first. Websites like Healthcare Bluebook provide estimated costs for medical treatments in your area. You may also ask your healthcare provider if you can pay the Medicare rate. Often, Medicare rates are lower than master rates (the maximum amount the hospital charges for a procedure).

3. Ask for a payment plan

In some cases, your healthcare provider may agree to set up a payment plan. Payment plans spread the cost of medical expenses over several months or years. Healthcare payment plans may even come with low interest rates—or no interest at all.

You can request a payment plan after negotiating your bill, too. But before you ask, consider your financial circumstances and determine how much you can afford to pay each month. Otherwise, you could get stuck with unaffordable installments.

4. Consider medical financing

Finally, you may consider financing your medical bills. As a general rule, it’s not a good idea to put your medical bills on a credit card—unless you know you can repay the balance in full by the payment deadline. Rolling medical costs can result in late fees or high interest charges that drive up your cost of debt.

That said, there are some more manageable forms of financing to consider, including medical credit cards and medical loans.

  • Medical credit cards are designed specifically for medical expenses. Some come with a 0% introductory APR period, which may last from a few months to several years. During this 0% interest period, you can make payments on your balance without any additional interest charges. However, interest will begin to accrue as soon as the window ends. So make sure you’ve repaid the balance in full.
  • Medical loans are a type of personal loan used to pay for healthcare expenses, such as emergency care, surgery, and other costs. Most medical loans are unsecured, which means they aren’t backed by personal property. At Upstart, our model looks beyond your credit score, considering factors like your work experience and education1 to help you find the right medical loan. This may allow you to access affordable financing that makes paying your medical bills more manageable.

How long does a medical provider have to bill you?

Hospital billing procedures vary based on location. Some providers will send one bill within a few weeks. Others may send multiple bills over the course of several months.

Keep in mind that most hospitals require you to pay your bill within 30—60 days of receiving it. That’s why it’s so important to identify any errors and begin the bill negotiation or settlement process as quickly as possible.

Can medical bills go to collections?

Medical debt can go to collections if it’s left unpaid. However, you won’t see medical collections on your credit report for 12 months. That means you have a year to pay off your medical debt before it can affect your credit score.

How to dispute medical collections on your credit report

Typically, you can dispute medical collections on your credit report if you’ve paid them off in full or if they’re erroneous.

If you find an error on your credit report, it’s important to gather evidence—such as receipts or bank statements—before requesting to have it removed.

On July 1, 2022, the 3 major credit bureaus decided to drop all repaid collections from credit reports. Thus, you shouldn’t see paid medical debt on your credit report. Previously, medical collections could remain on your credit report for up to 7 years, even if you paid it off in full.

If you determine there’s an error or find paid medical collections on your credit report, you can file a dispute with the credit agencies online, by mail, or over the phone. Learn more about the resolution process in the Consumer Financial Protection Bureau’s guide to disputing credit report errors.

Pro tip: Not sure if you have medical collections on your credit file? You can get a free copy of your credit report from AnnualCreditReport.com.

Make medical debt more manageable with affordable financing

Medical debt can be crushing. But rather than letting bills pile up, there are steps you can take to better manage your debt.

Negotiating a settlement and establishing a payment plan can help you take control of healthcare costs. Medical loans may be another affordable way to repay your debt and avoid the emotional burden of the collections process. 

No matter which method you choose, take some time to research your options, talk with your hospital’s billing department, and determine the best course of action for your circumstances.

¹ Neither Upstart nor its bank partners have a minimum educational attainment requirement in order to be eligible for a loan.

This content is general in nature and is provided for informational purposes only. Upstart is not a financial advisor and does not offer financial planning services. This content may contain references to products and services offered through Upstart’s credit marketplace.

About the Author

Upstart Content Team

The Upstart Content Team shares industry insights, practical tips, and borrower success stories to help people better understand the important “money moments” of their lives.

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