Your Rights With Medical Debt
Special protections for healthcare-related debts
Medical debt has unique protections under federal and state laws. Unlike other debts, medical bills often result from emergencies and unexpected health issues, and the law recognizes this with special consumer protections.
Special Protections for Medical Debt
1-Year Waiting Period
Medical debts cannot appear on your credit report until they are at least 365 days past due (as of 2022).
$500 Minimum Threshold
As of 2023, medical debts under $500 don't appear on credit reports at all.
Paid Debts Removed
Once paid, medical debts must be removed from your credit report (unlike other debts).
Balance Billing Limits
The No Surprises Act (2022) protects against surprise medical bills from out-of-network providers.
Your Medical Debt Rights
Right to an Itemized Bill
You can request a detailed, itemized bill showing every charge. Review it carefully for errors.
Right to Negotiate
Hospitals and providers often negotiate lower amounts, especially for uninsured or underinsured patients.
Right to Financial Assistance
Nonprofit hospitals must offer financial assistance programs. Ask about charity care policies.
Right to Payment Plans
Providers typically offer interest-free payment plans. They cannot charge interest unless you specifically agree to it.
Right to Dispute Errors
Challenge incorrect bills, duplicate charges, services not received, or insurance processing errors.
Protection from Balance Billing
For emergency care and certain non-emergency situations, you're protected from excessive out-of-network charges.
Steps to Take When You Receive a Medical Bill
Don't Panic or Pay Immediately
Medical bills often contain errors. Review carefully before paying anything.
Request Itemized Bill
Get a detailed breakdown of all charges. Compare against insurance Explanation of Benefits (EOB).
Check Insurance Processing
Ensure your insurance was billed correctly and processed all covered services.
Look for Errors
Common errors: duplicate charges, incorrect codes, services not received, wrong insurance info.
Negotiate or Apply for Assistance
Contact the billing department to negotiate or apply for financial assistance programs.
Financial Assistance Programs
Many people don't know these programs exist. They can significantly reduce or eliminate your bill:
Charity Care
Nonprofit hospitals must provide free or reduced-cost care based on income. Ask about their charity care policy.
- Often available up to 200-400% of federal poverty level
- May cover 100% of costs
- Application required
Financial Hardship Programs
For-profit hospitals and clinics often have hardship programs for those struggling to pay.
- Income verification required
- Can reduce bills by 50-90%
- Must apply before debt goes to collections
Payment Plans
Interest-free payment plans are standard. Negotiate terms that work for your budget.
- Usually no credit check
- No interest if arranged with provider
- Flexible term lengths
How to Negotiate Medical Debt
1. Know the Cash Price
Ask what they would charge an uninsured cash-paying patient. This is often 40-60% less than billed amount.
2. Offer Lump Sum
If you can pay a lump sum, offer 25-50% of the bill. Many providers accept this to avoid collection costs.
3. Request Supervisor
Billing staff often have limited authority. Ask to speak with a supervisor or financial counselor.
4. Get It in Writing
Any agreement must be in writing before you pay. Confirm they'll mark account as "paid in full."
5. Don't Use Credit Cards
Paying with credit card transfers the debt and you lose protections. Use payment plans instead.
When Medical Debt Goes to Collections
Before Collections
- Negotiate with provider directly
- Apply for financial assistance
- Set up payment plan
- Debt doesn't appear on credit report for 1 year
In Collections
- All FDCPA protections apply
- Request debt validation
- Check if debt is time-barred
- Negotiate settlement (get in writing)
- Won't appear on credit if under $500
Common Medical Billing Errors
Duplicate Charges
Being billed twice for the same service or procedure
Incorrect Coding
Wrong medical codes leading to higher charges or denied insurance
Balance Billing
Being charged the difference between in-network and out-of-network rates
Services Not Received
Charges for procedures, tests, or medications you never got
Incorrect Patient Info
Wrong insurance information leading to denied claims
Unbundling
Charging separately for services that should be billed together
Medical Debt and Bankruptcy
Medical bills are the #1 cause of bankruptcy in the US. If overwhelmed:
- Medical debt is unsecured and dischargeable in bankruptcy
- Chapter 7 can eliminate medical debt entirely
- Chapter 13 allows payment over 3-5 years
- Consult a bankruptcy attorney for free consultation
- Consider this only after exploring all other options
Resources for Help
Patient Advocate Foundation
Free help with medical debt: patientadvocate.org
Dollar For
Database of charity care programs: dollarfor.org
RIP Medical Debt
Nonprofit that buys and forgives medical debt: ripmedicaldebt.org
Medical Billing Advocates
Professionals who review and negotiate bills: AMBA.org
Medical Debt is Different
Don't let medical debt ruin your credit or finances. Use your special protections and always negotiate.