Key takeaways
- Medical bills often contain mistakes. Ask for an itemized bill and check it.
- Nonprofit hospitals must have financial assistance policies. You may qualify even after the bill was sent to collections.
- Medical debt collectors must follow the same federal rules as other collectors.
- Under the credit bureaus’ current policies, paid medical collections and those under $500 shouldn’t appear on your credit reports.
- Get any payment plan or settlement in writing.
Medical debt is different from most debt. You usually didn’t shop around, you may not have known the price in advance, and insurance may still be sorting things out. If a medical bill has gone to collections, you have more options than you might think. Start here.
Step 1: Make sure the bill is right
- Ask for an itemized bill from the provider, listing every charge.
- Compare it with your insurer’s explanation of benefits. Look for services you didn’t get, duplicate charges or charges insurance should have covered.
- Call your insurer if a claim was denied or not filed. You may be able to appeal.
- If a collector contacted you, ask for the validation notice and dispute anything that looks wrong. See how to ask a debt collector to prove a debt.
Step 2: Ask about financial assistance
If the bill came from a nonprofit hospital, it must have a written financial assistance policy. According to the IRS, these policies offer free or discounted care to patients who meet the hospital’s criteria, and the hospital must make the policy widely available, including on its website.
The IRS also explains that tax-exempt hospitals must make reasonable efforts to find out whether you qualify before taking certain extraordinary collection actions, under its billing and collections rules.
Ask the hospital’s billing office for an application, even if the bill is already with a collector. Many for-profit providers also offer discounts or payment plans if you ask.
Step 3: Know your rights with collectors
Medical debt collectors must follow the same federal rules as other debt collectors: limits on when and how often they call, no threats or lies, and written information about the debt. Read your rights when a debt collector calls.
If you’re sued over medical debt, respond by the deadline. See what to do if you’re sued for a debt.
Medical debt and your credit report
According to the CFPB, the three nationwide credit bureaus, Equifax, Experian and TransUnion, have removed medical collections that are:
- Already paid,
- Under $500, or
- Less than a year old.
These are the bureaus’ own policies, not a federal law, so they could change. A CFPB rule that would have gone further was struck down by a federal court in 2025. Some states have their own laws that limit medical debt reporting.
Check your reports for free at AnnualCreditReport.com. If you see a paid or small medical collection, dispute it. Our guide on how to dispute a credit report error shows how.
Options for paying it
- Ask for a discount for paying in a lump sum, or for a reduced amount based on your income.
- Ask for an interest-free payment plan. Many providers offer them.
- Negotiate with the collector. Get any agreement in writing before you pay. See can you negotiate credit card debt yourself; the same steps apply.
- Be careful about medical credit cards or loans. Moving medical debt to a card with deferred interest can cost more if you don’t pay it off in time.
What to avoid
- Paying a bill you haven’t checked. Errors are common.
- Putting medical bills on a high-interest credit card before asking about assistance and payment plans.
- Ignoring letters. You can miss dispute deadlines and court dates.
Where to get help
- The hospital’s financial counselor or billing office.
- A nonprofit credit counselor through the NFCC, to fit medical bills into your overall budget.
- Legal aid, if you’re sued.
- Your state attorney general or insurance regulator, for billing or insurance disputes.
The bottom line
Check every medical bill, ask about financial assistance, and know that paid and small medical collections shouldn’t be on your credit report under current bureau policies. Then pay what’s right on terms you can afford, and get it in writing.
Sources: CFPB: paid or under $500 medical debt should no longer be on your credit report · IRS: financial assistance policies · IRS: billing and collections, section 501(r)(6)