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 independently from the TIME editorial staff. To learn more, see our About page.

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

FAQs

What Happens When Medical Bills Go to Collection? ›

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.

Should I worry about medical bills in collections? ›

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.

What happens if you never pay collections? ›

If you don't pay, the collection agency can sue you to try to collect the debt. If successful, the court may grant them the authority to garnish your wages or bank account or place a lien on your property. You can defend yourself in a debt collection lawsuit or file bankruptcy to stop collection actions.

Can medical bills that go to collections affect your credit? ›

Paid medical collections don't appear on credit reports. Once the waiting period is over, the collection account will pop up on your credit profile. Unless you pay the collectors, it will stay there for seven years and can negatively affect your scores.

How long until a medical bill goes to collections? ›

Collections. ‍Hospital bill collections cannot legally start until 120 days after the hospital first sent you your bill, or the “statement date” printed on your bill. If your hospital is billing you for multiple procedures, the 120 days starts ticking from the statement date on the bill for your most recent procedure.

Can medical bills under $500 go to collections? ›

Key takeaways. The major credit reporting agencies have initiated a change so that medical bills of less than $500 will not show up on your credit report after going to collections.

Can I negotiate a medical bill in collections? ›

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.

What's the worst a debt collector can do? ›

The worst thing they can do

If you fail to pay it off, the collection agency could file a suit. If you were to fail to show up for your court date, the debt collector could get a summary judgment. If you make an appearance, the collector might still get a judgment.

Why should you never pay a debt collector? ›

A collection account can significantly damage your credit score, but the impact lessens over time. Paying off a collection might not immediately improve your credit score, but some newer credit scoring models give less weight to paid collections.

What happens if I ignore a debt collector? ›

If you get a summons notifying you that a debt collector is suing you, don't ignore it. If you do, the collector may be able to get a default judgment against you (that is, the court enters judgment in the collector's favor because you didn't respond to defend yourself) and garnish your wages and bank account.

Do medical collections count against you? ›

It's always best to pay off legitimate medical debt—and when it comes to your credit scores, it can make a big difference. Unpaid medical collection accounts over $500 can appear on your credit reports and affect your credit scores for up to seven years.

Is it a HIPAA violation to send medical bills to collections? ›

Yes, healthcare providers can share protected health information (PHI) with debt collectors under specific circ*mstances without violating HIPAA. Debt collection is considered a payment activity under HIPAA, so sharing necessary information with debt collectors is permitted.

How to remove medical collections from credit report? ›

After seven years, medical collections will drop off your credit reports, even if you haven't paid them off. And if you pay them off at any time, they'll be removed from your reports.

What happens if you don't pay medical bills in America? ›

You can take steps to make sure that the medical bill is correctly calculated and that you get any available financial or necessary legal help. If you do nothing and don't pay, you could be facing late fees and interest, debt collection, lawsuits, garnishments, and lower credit scores.

How to pay a bill in collections? ›

The most secure way to pay a debt collection agency is by mailing a check with a return receipt. This will prove that the collection agency accepted the check. It costs $2.20 for an electronic receipt and $3.55 for a mailed receipt. These receipts will be handy if the collection agency claims you didn't make a payment.

How many people are in debt because of medical bills? ›

This analysis of government data estimates that people in the United States owe at least $220 billion in medical debt. Approximately 14 million people (6% of adults) in the U.S. owe over $1,000 in medical debt and about 3 million people (1% of adults) owe medical debt of more than $10,000.

Do medical collections ever go away? ›

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.

How to avoid medical bills going to collections? ›

Tips to Avoid Your Medical Bills from Hitting Collections
  1. Tip 1: Take a deep breath and open your bills. ...
  2. Tip 2: Read the details. ...
  3. Tip 3: Talk to your healthcare providers. ...
  4. Tip 4: Negotiate. ...
  5. Tip 5: Be proactive. ...
  6. Tip 6: Ask for a Lump Sum Discount. ...
  7. Tip 7: Get familiar with Charity Care. ...
  8. Tip 8: Stay organized.

What is considered bad debt in medical billing? ›

Bad debt in healthcare represents an estimate for a bill that the patient or other payor cannot, or will not, pay. Bad debt is also referred to as uncompensated care. Some healthcare providers will report a bad debt as the difference between what a patient was billed and the amount of the bill that was paid.

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