How to Pay Off Medical Debt

Hospitals typically allow patients up to 240 days from the time they receive a bill to apply for charity care. Patients can still apply within that time frame even if the bill has been turned over to a collection agency, and hospitals must pull the bill out of collections if the application is approved.

Dollar For helped Urquidez prepare and submit applications for financial assistance from a hospital where he received emergency care for infections and complications that arose after his initial injury. The hospital forgave nearly $3,700 of what he owed.

Ask for an itemized bill

If you’re not eligible for financial assistance, Walker recommends calling your provider’s billing department to request an itemized statement that shows, line by line, all the costs for treatments you received and the corresponding Current Procedural Terminology (CPT) codes used for billing. 

Why? Because many medical bills contain errors, such as double billing for tests, treatments or medications, Walker says. Older adults, who typically need more frequent and more complex care, face a greater risk of incorrect charges, according to the Consumer Financial Protection Bureau (CFPB).

Just the act of printing out an itemized statement gives the billing office an opportunity to catch and fix mistakes, but even if they do, review the bill yourself. Compare it with the explanation of benefits (EOB) you received from your insurer, or the Medicare Summary Notice (MSN) if you have Medicare coverage, to make sure all the charges are accurate.

You can use the Fair Health Consumer’s Cost Lookup tool to input the CPT codes from your bill and see if you were charged a fair price for the services you received. If you were charged more than the going rate, you can use that information when negotiating with the provider.

Also, check whether you were charged for seeing any out-of-network providers at a facility that was in your insurance plan’s network. “Balance billing” — when out-of-network providers bill you for the difference between what they charge and what your insurance plan covers — is largely prohibited by the federal No Surprises Act. If you received a surprise out-of-network bill, you can file a complaint with the Centers for Medicare & Medicaid Services’ No Surprises Help Desk.

File an appeal

If you have medical bills because your insurance company denied coverage for a treatment, you have 180 days after receiving a denial notice to file for an internal appeal — a request that the company review the case and reconsider its decision. If the denial stands, you can request an external review by an independent third party; the insurer’s denial letter should include contact information for an organization that can conduct the external appeal.

You may be able to get assistance filing an internal or external appeal if your state has a Consumer Assistance Program. Alternatively, you could hire a patient advocate, also known as a medical billing advocate, to review your medical bill for errors and assist you in appealing an insurance denial. You can find one through the National Association of Healthcare Advocacy or Umbra Health Advocacy. There’s also the Patient Advocate Foundation, which provides assistance to people with chronic, life-threatening or debilitating diseases.

If you told a health care provider that you weren’t going to use insurance and received a good-faith estimate of costs three days before your appointment, you can dispute a bill that is more than $400 over the estimate you were provided. You have 120 days from the date you received the bill to submit a dispute with the Centers for Medicare & Medicaid Services. 

You also have the right to appeal denied Medicare claims. Contact your State Health Insurance Assistance Program (SHIP) or call 877-839-2675 to get help submitting an appeal. 

Negotiate a lower bill

Walker recommends asking hospitals or large medical practices about the “settlement amount” for your bill. “That is the magic word,” he says. “It means, ‘I’ve got cash, and I’m willing to give you cash if we can close it out today.’ ”

When negotiating a settlement, McClary advises starting with an offer to pay 50 percent or less of your account balance. “Start low and have flexibility to work up,” he says. Persistence is key — it may take several calls before you reach someone in the billing department who is willing to negotiate.

Depending on your situation, a patient advocate may be able to help you negotiate your medical debt.

If you reach a settlement agreement, get it in writing. “Don’t take their word over the phone, an informal handshake, a high-five,” McClary says. “None of that is worth anything.” Also, ask for a confirmation statement after you’ve paid the negotiated amount.

Inquire about a payment plan

Your health care provider might be willing to let you pay what you owe in installments — but be careful about what you agree to. “Don’t get bullied into a payment plan you can’t afford,” says Sesso.

Request an interest-free payment plan and a payoff period that’s feasible for you. Get the plan in writing, and make sure the agreement doesn’t require you to pay your bill in full if you miss a payment. Also, confirm that the debt won’t be turned over to a collection agency while you’re on the payment plan, and ask to receive statements showing your progress toward paying off the balance.  

Owe money to multiple providers? You may get a better outcome by working with a credit counseling agency. You can find a free or low-cost certified credit counselor through the NFCC. This professional can reach out to your creditors and negotiate a payment plan where you make monthly payments to the counseling agency, which distributes the money to your creditors, McClary says.

Don’t pay with a credit card

“Putting medical debt on a credit card is a big no-no,” says Berneta Haynes, an Atlanta-based senior attorney with the National Consumer Law Center.

Once you charge medical debt to a credit card, you can no longer apply for financial assistance. You also give up the ability to negotiate a payment plan with the provider. And, if you carry a balance, you’ll have to pay interest charged by the credit card issuer on top of the money you owe the health care provider. 

“You don’t want to deal with those high interest rates that will turn your debt into something worse than what you started with,” Haynes says.

Another reason to avoid paying with a credit card: Unlike credit card debt, medical debt might not show up on your credit report, depending on where you live and how much you owe (or for how long).

While a CFPB rule that would have kept medical debt off credit reports was struck down by a federal court in July 2025, 15 states have laws that do so. Additionally, the three major credit bureaus — Equifax, Experian and TransUnion — have voluntarily agreed not to include medical debt that’s less than $500 or has been delinquent for less than a year on their reports.

Know your rights if a bill goes to collections

Bill Waxman found himself thousands of dollars in debt after three hernia surgeries in 2012. “There were nights I couldn’t sleep because I couldn’t figure out where I was going to get the money to pay the hospital,” says Waxman, who is 64 and lives in Orlando, Florida.

Because he wasn’t able to negotiate a payment plan he could afford, the hospital turned Waxman’s debt over to a collection agency, which he says hounded him for years with calls, emails and letters — until Undue Medical Debt notified him in 2024 that it had paid off his $7,150 bill.

If your debt is sold to a collection agency, Haynes says, it’s important to understand your rights under the federal Fair Debt Collection Protections Act. Collectors can’t harass you, mislead you or contact you before 8 a.m. or after 9 p.m. They’re also required to stop contacting you if you send them a letter asking them to do so. (The CFPB offers a sample letter.)

If a collection agency sues you for the debt, you might qualify for free legal assistance from your local legal aid office. People 60 and older typically qualify, as do adults whose income falls below certain thresholds.