Navigating Medical Debt: Steps to Take When You Can’t Pay 

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Feeling overwhelmed by medical debt is a common experience, not a personal failing. Many Americans are in the same boat, with collective medical debt estimated at over $220 billion. 

Root Causes of Medical Debt 
Two primary factors drive the rise in medical debt: the high cost of healthcare and the lack of insurance coverage. Many people struggle to pay their medical bills on time, leading to severe consequences such as skipping necessary care, draining savings, damaging credit, and even filing for bankruptcy. 

The Impact of Medical Debt 
Medical debt affects millions of Americans, especially those without adequate insurance. Bankruptcy is often a last resort for managing overwhelming medical bills, but unpaid bills can also harm your credit score and financial stability. Here are some steps to manage and reduce medical debt. 

Key Strategies to Manage Medical Debt 

1. Check for Errors: 
Many medical bills contain errors. Reviewing your insurance statements and healthcare provider bills for duplicate charges or services not received is crucial. Comparing these bills to your medical records can help identify mistakes. If you find discrepancies, contact your insurance company or the billing department for clarification. 

2. Negotiate Your Bill: 
Contact your healthcare provider’s billing manager to discuss your bill. Don’t wait until the bill is delinquent. Request hardship assistance if you have low income or significant financial difficulty. Comparing your charges to those in your area using resources like or can support your case for lower rates. 

3. Advocate for Yourself: 
Offer to pay a portion of the bill immediately in exchange for a discount. If full payment isn’t feasible, ask about interest-free payment plans. Ensure any agreed terms are documented in writing. 

4. Seek Outside Help: 
If navigating medical bills is too daunting, enlist a medical billing advocate, caseworker, or debt negotiator. These professionals can help reduce what you owe by identifying errors and negotiating on your behalf. Some charge a fee based on the amount they save you, while others charge hourly rates. 

Special Considerations 
In 2022, major credit reporting agencies implemented measures to reduce the impact of medical debt on credit scores. These include removing paid medical debt from reports, delaying the appearance of medical debt in collections on credit reports, and excluding debts under $500. The Biden administration also introduced measures to protect consumers from abusive collection practices and to exclude medical debt from federal loan applications. 


What happens if you don’t pay medical debt? 
Unpaid medical debt can be sent to collections, potentially leading to lawsuits, wage garnishment, or bank account levies. 

Do unpaid medical bills ever go away? 
Unpaid medical debt may become uncollectible after a state’s statute of limitations expires, but this doesn’t erase the debt or its impact on your credit. 

Can medical debt be forgiven? 
Creditors may agree to a debt settlement, allowing you to pay less than owed. This can be negotiated independently or through a debt settlement company. 

Does unpaid medical debt hurt your credit? 
Yes, it can. However, new measures by credit bureaus aim to lessen the impact of medical debt on credit scores. 

The Bottom Line 
The inequities of the U.S. healthcare system leave many vulnerable to unmanageable medical expenses. Ensure your medical bills are accurate, negotiate for lower charges, and understand your rights regarding medical debt collections. Seek professional help if needed. 

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