How to pay medical bills


When she was 19, writer Emily Maloney found herself nearly $50,000 in debt after being hospitalized for mental health issues. The debt haunted her for twenty years, damaging her credit and causing stressful calls from collection agencies.

Her experience is all too common: The Consumer Financial Protection Bureau reports that about 1 in 5 US households have medical debt. People with medical debt are more likely to experience anxiety, stress, or depression and avoid prescriptions because of the cost.

The risk of “medical debt looms large over every consumer and affects their lives,” said John McNamara, assistant director of the CFPB’s consumer credit, payment and deposit markets. He adds that recent changes to how the credit bureaus report medical debt should help consumers: Paid medical debt will no longer appear on credit reports, and new medical debt will not appear until 12 months will pass (compared to six). In addition, credit bureaus will stop reporting unpaid medical debt of less than $500 in the first half of next year.

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In the end, Maloney’s debt was resolved through a combination of a helpful customer service representative and her state’s statute of limitations. She wrote a book called “The Cost of Living” based on her experiences. She wants to reassure others facing medical debt that they can take steps to reduce it.

“It takes time, but you can appeal the insurance company’s decision or ask (the provider) for a discount, so it’s worth a try,” she says.

In other words, consumers may have more power than they think. Here are some ways to exercise that power over yours medical debt.

You may be tempted to shove a large bill in the trash in frustration. But Dan Weissman, creator of the Arm and Leg podcast about the cost of health care, recommends looking closely at mistakes made by your health care provider or insurance company instead.

“It’s an unfair amount of homework for us because if you find an error, then you have to complain and invest your time, but some medical bills have errors,” he says.

Weissman says it’s also worth checking your rights under the Surprise Act, which went into effect in January 2022 and protects consumers from certain types of unexpected medical bills.


Many hospitals offer financial assistance to those who meet income thresholds. “If you get an amount you didn’t expect, call the hospital and say, ‘Am I eligible for a discount?’ What’s your policy on financial assistance?” says Richard Gundling, vice president of the Healthcare Financial Management Association, an association of healthcare finance executives.

Hospitals often have “charity care” policies to provide a lower price or even full debt forgiveness, but consumers may need to be aggressive in asking for them. Eligibility for programs varies by state and hospital, but nonprofit hospitals must have a financial assistance policy. Hospitals may also offer payment plans to give you more time to pay.

Hospitals can also hook you up with financing options like personal loans and medical credit cards, which can be helpful but also carry risks. The CFPB’s McNamara warns that credit cards, for example, can charge extra interest.


Lorraine Coughlin, president of LMC Medical Claims Management in West Palm Beach, Florida, helps people settle medical bills with insurance companies for a living. She says the number one strategy is persistence.

“You have to call and ask questions. Don’t just make payments when you get an unexpected bill,” she says. Sometimes it can take an hour or more, but that call can save you thousands of dollars, she says.

Medical bill advocates like Coughlin can do this for you, but they usually charge a fee and a percentage of any savings. McNamara warns that there are predators who call themselves billers or consumer advocates, but in reality they may take your money without providing any real help. He recommends doing some research before sharing personal information or paying upfront fees.

If you’re having trouble getting satisfactory answers from your insurance company and you’re working, Gundling suggests reaching out to your company’s benefits contact for help. “They can be your advocates,” he says.


The perfect time to work on handling medical debt is before you have it, Gundling says. With the rise of high-deductible health insurance plans, even people with insurance will increasingly face expensive bills, making an emergency fund even more important.

“If you know you have a plan with a high deductible, have money in the bank,” he says.

You can try putting money away through automated deposits into a high-yield savings account or take advantage of a flexible health savings account if your employer offers one.

Similarly, Gundling suggests asking questions about what your insurance covers and which providers are in-network before seeking care, if possible.

The bottom line is that attacking rather than ignoring medical debt may be your best hope of eventually putting it behind you, as Maloney did.

This column was provided to The Associated Press by personal finance website NerdWallet. Kimberly Palmer is NerdWallet’s personal finance expert and author of Smart Mom, Rich Mom. email: Twitter: @KimberlyPalmer.

NerdWallet: How to pay off your medical debt: 6 options

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