What Happens When Medical Bills Go to Collection? (2024)

Nearly everyone faces an unexpected medical bill from time to time. Some are lucky enough to have a comprehensive health insurance policy that covers all or most of their bills. Others have the financial wherewithal to handle the cost.

However, many aren’t so well protected. According to the White House, one in three Americans have medical debt. Of that debt, according to the Consumer Financial Protection Bureau, $88 billion is in collection. If you can’t pay your medical bills, the medical provider can sell your debt to a collection agency to recover the unpaid amount. This can affect your credit score negatively, which can damage your ability to secure loans.

How does medical debt in collection affect your credit?

The good news is that medical debt is now treated less harshly than other types of consumer debt.

According to the Consumer Financial Protection Bureau (CFPB), it used to be that most healthcare providers started selling outstanding debt to collection agencies after 60 to 120 days or more past due. However, recent legislation (see “What is the 2021 Medical Debt Forgiveness Act?” below) has changed that period to one year past due.

Even better, the CFPB said that the three largest credit bureaus—TransUnion, Equifax, and Experian—announced that all paid medical debts and unpaid debts less than a year old would be removed from credit reports. In April 2023, they extended this to all medical collections under $500.

This extra time gives you more to work with your insurance company and medical provider to try to create a payment plan that keeps that debt from reaching a collection agency.

How to pay off medical debt

The first step is to make sure that you actually owe everything that is on your bill. Scrutinize each item to see if it is correct. The Centers for Medicare and Medicaid Services has a useful checklist to help you with this task. And double-check with your insurance company to make sure it has paid for everything it is supposed to cover.

Reach out to your medical provider to see if it’s possible to create a payment plan that works for you. Some may offer a medical credit card option. Both of these have risks and can affect your credit. But they could keep your medical debt out of a collection agency. In fact, if you do set up a plan, always put that agreement in writing. Make sure that the plan explicitly states that as long as you are meeting its terms, the provider will not send the unpaid balance to a collection agency.

Another place to look for funds is to take a hardship loan from your 401(k). This is generally not advisable because it endangers your future. But in an emergency, you will not be penalized for withdrawing funds and will be able to pay them back later, with interest that goes to you, not a bank.

Other ways to pay off medical debt are to take out a loan or acquire a 0% interest rate credit card.

What to do when your medical bills go to collection

If nothing works and your medical bills arrive at a collection agency, it’s time to act. Contact the agency right away and see what you can do to get the bill paid. Needless to say, paying off the bill fast—the best option—is not always possible. There are two widely used alternatives to consider.

Debt management plan

One helpful next step is to work with a nonprofit credit counseling agency to set up a debt management plan to pay off the debt. This generally involves setting up a three-to-five–year program in which you pay the counseling agency and it pays the collection agency. This will likely do less damage to your credit than the next alternative.

Debt settlement

This strategy involves negotiating what’s called a “settlement” with the collection agency, which means that you agree to pay a portion of the debt. Settling is preferable to continuing to be late on payment and going into default. However, the problem with accepting a settlement is that, because you have not paid the full amount owed, the unpaid portion may remain on your credit report as a negative mark for seven years.

How to rebuild your credit after medical collections

You can always remake your credit profile, even if delinquent bills have gone to a collection agency. There are three steps to take:

  1. Pay off your bill (and any others outstanding) in full.
  2. Pay all new bills on time.
  3. Pay down your credit card balances.

The last is especially important, because those balances affect your credit utilization ratio, which helps to determine your FICO score. It is calculated as a percentage. Add up your total debt, divide it by your total credit limit, and multiply by 100. Experts recommend that you don’t let your credit utilization ratio exceed 30%.

Beware: Bills can be sent to collection even if you’re paying

You’re moving along paying off a medical bill, and, surprise, your unpaid balance ends up in collections. What gives?

As noted above, even if you’re paying off your bill, the provider can still send the unpaid balance to a collection agency. That’s why it’s essential to work out a payment plan with the provider and always get that agreement in writing. If no payment plan seems feasible, then it’s time to try negotiating a debt management plan or settlement agreement with the agency.

Insurance doesn’t cover everything

Your health insurance may pay for the bulk of your visits to your primary care doctor, referrals to see some specialists, treatment at a hospital, and other costs. However, there are many costs that health insurance doesn’t cover, and there are deductibles, copays, and premiums you must always factor into your medical expenses.

Be sure to study your health insurance policy to understand the parameters of your coverage. Call its help line to clarify points—ideally before a medical emergency occurs.

What is the 2021 Medical Debt Forgiveness Act?

The 2021 Medical Debt Forgiveness Act is designed to help Americans who are dealing with medical debt by forgiving the debt and helping them get back on their feet financially. It states that a consumer protection agency is forbidden from adding medical debt information to a consumer credit report if the debt was fully paid or settled or is less than a year old. In addition, a debt collector must notify the individual before reporting medical debt to a consumer reporting agency.

Can I stop medical bills from affecting my credit?

As noted above, many protections have been enacted to prevent medical debt from ending up on your credit report. This gives you more time to find a way to pay off, or settle, the debt.

However, any debt that isn’t protected will show up on your report and negatively affect your credit score. Once that happens, all you can do is work to pay off or settle the debt as quickly as you can.

TIME Stamp: Act quickly if medical debt winds up at a collection agency

If your unpaid medical bills go to a collection agency, it’s not the end of the world. You can work with the agency to find the best way to pay off the debt, whether through monthly payments or a settlement that dismisses a portion of the debt, and make sure that it is eventually erased from your credit report.

Frequently asked questions (FAQs)

Does the record of unpaid medical bills go away after seven years?

Yes, it does. However, you are still responsible for the unpaid amount, and the credit score impacted by the debt could affect your status when you apply for a loan, an apartment, or a job.

How can I get medical bills off my credit report?

Contact the collection agency and the medical provider to ensure that inaccurate information about unpaid medical bills is taken off your credit report.

Do outstanding medical bills affect your credit when buying a house?

They certainly can. A low credit score caused by bills in collection can lead to a higher interest rate on a mortgage or even prevent you from buying a house.

The information presented here is created by TIME Stamped and overseen by TIME editorial staff. To learn more, see our About Us page.

What Happens When Medical Bills Go to Collection? (2024)

FAQs

What Happens When Medical Bills Go to Collection? ›

If you are not able to come to an agreement with the provider and they sell your debt to a collection agency that reports to the credit bureaus, the unpaid collection account can remain part of your credit history for seven years from the original delinquency date.

Will medical debt collectors settle for less? ›

For medical debt, it is common to negotiate to a lower amount than you were originally billed. For medical debt, creditors will typically settle for roughly the amount insurance companies pay for the same services, which is usually much lower than the amount that would be billed to an uninsured person.

Should I worry about medical bills in collections? ›

Once medical bills enter collections, they are often reported to consumer credit reporting companies. Medical debt collections on a credit report can impact your ability to buy or rent a home, raise the price you pay for a car or insurance, and make it more difficult to find a job.

How do you negotiate a medical bill collection? ›

Unlike many other types of debt, medical bills can often be negotiated. See if your provider offers any discounts for things like paying as a lump sum (provided you can afford it). Many hospitals also have bill relief programs that can help decrease your bill if you meet certain criteria for financial assistance.

What is the new rule for medical collections on credit reports? ›

Following the release of a CFPB report in March 2022 that found that Americans owed $88 billion in unpaid medical bills, the three largest credit reporting agencies announced that they would no longer include paid medical debts, unpaid medical debts less than a year old, and medical debt under $500 from credit ...

What is the lowest a debt collector will settle for? ›

Some will only settle for 75-80% of the total amount; others will settle for as a little as 33%. Looking for a place to set the bar? The American Fair Credit Counsel reports the average settlement amount is 48% of the balance. Again, start low, knowing the debt collector will start high.

What happens if a debt collector won't negotiate? ›

If the debt collector won't negotiate, your best option would be to contact the initial creditor that sent your debt to the collector. That creditor might be willing to compromise with you. You could also suggest to the debt collector that if he or she refuses to settle, you will be forced to file for bankruptcy.

How long until medical debt is forgiven? ›

Judgments stay either seven years or until the statute of limitations in your state is up, whichever is longer. And here's one more caveat: While unpaid medical bills will come off your credit report after seven years, you may still be legally responsible for them depending on the statute of limitations.

What happens if you never pay collections? ›

Persistent attempts to collect the debt may result in increased pressure from the collector, including frequent phone calls, letters, or even legal actions such as lawsuits. Ignoring these efforts could lead to further financial strain, potential wage garnishment, or the seizure of assets through a court judgment.

What to say to medical debt collectors? ›

I am writing to negotiate the above medical bills because I am unable to pay the amount requested. Pursuing me for these bills will force me (and my family) into further financial hardship. This is where you explain your current financial situation and why you are unable to pay.

What percentage should I offer to settle a debt? ›

What Percentage Should You Offer to Settle Debt? Consider starting debt settlement negotiations by offering to pay a lump sum of 25% or 30% of your outstanding balance in exchange for debt forgiveness. However, expect the creditor to counter with a request for a greater amount.

What is a good collection rate for medical billing? ›

The Medical Group Management Association (MGMA) recommends a net collection of 95% or higher.

How to resolve medical bills in collections? ›

If you are trying to take care of a medical debt that has already been sold to collections, here are some steps you can take:
  1. Contact the collection agency to work out payment arrangements. ...
  2. Understand the statute of limitations. ...
  3. Check to make sure your credit reports are updated. ...
  4. Dispute inaccurate information.
Mar 31, 2023

Is it true that all medical collections are $500 will automatically be removed from my credit report? ›

Only unpaid medical collections with a starting balance of $500 or higher will show up on your reports, where they'll stay until they're paid or for seven years. Why seven years?

How much medical debt gets written off? ›

The three nationwide credit reporting companies – Equifax, Experian, and TransUnion – also removed all paid medical debts from consumer credit reports and those less than a year old. They have also taken steps to remove all medical collections under $500.

Can medical bills under $500 be sent to collections? ›

As of April 2023, medical debt under $500 in collections and any medical debt that's been paid off no longer appears on consumers credit reports. Likewise, medical debt over $500 is not reported to the credit bureaus until a year after going to collections.

What percentage should I offer to settle debt? ›

Start by lowballing, and try to work toward a middle ground. If you know you can only pay 50% of your original debt, try offering around 30%. Avoid agreeing to pay an amount you can't afford.

Can I ask a collection agency to settle for less? ›

They may be open to negotiating a lower repayment, especially if you can pay it upfront. In many cases, accepting a reduced payment could be in the debt collector's best interests.

Does negotiating medical debt affect credit? ›

Fortunately, your healthcare bills won't harm your credit, as long as you don't wait too long to settle them. Most of the time, you're dealing with the medical provider directly and they aren't likely to report your payment activity (or lack thereof) to the credit bureaus.

How to negotiate a medical bill script? ›

To Whom It May Concern: I am writing to negotiate the above medical bills because I am unable to pay the amount requested. Pursuing me for these bills will force me (and my family) into further financial hardship. This is where you explain your current financial situation and why you are unable to pay.

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