What happens if you don't pay a medical bill?

Statements and phone calls from the billing office. When the account moves to collections is mostly the provider's decision. A nonprofit hospital has to wait at least 120 days before it can report the bill or sue over it, which the next question covers. Either way, this stretch is when the bill is easiest to change.

Start with an itemized bill, a line-by-line list of every charge. Billing records are part of your medical record under HIPAA, so a written request for them gets the same 30-day deadline as any records request. Check each line against what happened: the dates, the number of scans, the nights in the hospital.

Our free medical bill letter writes that request. It also writes the ones that can come after it: a dispute of a wrong charge, an application for financial assistance, an offer of a lower amount, or a request for a payment plan.

If the hospital is a nonprofit, federal tax rules set a floor. It can't take what the IRS calls extraordinary collection actions until at least 120 days after the first bill it sends once you've left the hospital, and it has to give you 30 days of written notice before it starts. Those actions include selling the debt, reporting it to the credit bureaus, suing, putting a lien on property, garnishing wages, and putting off needed care because of the unpaid bill.

The same rules give you at least 240 days from that first bill to apply for the hospital's financial assistance. Every nonprofit hospital has to have a written financial assistance policy. Send a complete application inside that window and the hospital has to suspend those actions while it decides.

For-profit hospitals, and doctors' offices that bill separately, fall outside these rules and set their own timing. So ask the billing office whether the hospital is a nonprofit.

Not soon, and not if it's small. Equifax, Experian and TransUnion stopped listing paid medical collections in 2022. They now wait a year before an unpaid one can appear, and since April 2023 they've left off medical collections under $500. A nonprofit hospital may report a bill after 120 days, but the bureaus still wait out their year.

Those are the bureaus' own policies, and no federal law requires them. In January 2025 the Consumer Financial Protection Bureau finished a rule that would have kept medical bills off credit reports altogether. The CFPB estimated it would have taken $49 billion in medical bills off the reports of 15 million Americans. In July 2025 a federal court in Texas struck the rule down, and the CFPB agreed it had gone beyond its authority. Some states have their own limits, and several of those are being fought in court too.

So a bill of $500 or more that's still unpaid after a year can show up on your report. Paying it takes it off.

A collector has to send you a validation notice that says what it thinks you owe. You then have 30 days to dispute the debt in writing, and the notice gives the end date. If you dispute in time, the collector has to stop trying to collect the amount you dispute until it answers.

Dispute anything you haven't checked: a charge insurance should have paid, a duplicate, a bill that isn't yours. And no matter how a call goes, a collector can't threaten to have you arrested over the debt.

You can be sued. A provider or a collector can take you to court for the balance. In a 2022 KFF survey of adults with health care debt, 6% said a provider had sued them in the past five years. If the court rules against you, the judgment can lead to garnishment of your pay. Federal law caps that at 25% of your disposable earnings a week, less on a low income, and a lower state limit wins.

You can't go to jail for owing the money. But if a court orders you to appear and you don't, a judge can issue a warrant for your arrest. That's why the one piece of mail never to ignore is anything from a court.

Lawsuits also run out of time. Most states allow between three and six years, and some allow longer. After that, a collector can't sue you or threaten to. Be careful with small payments on an old bill: a payment, or saying you owe it, can restart the clock.

Generally not. You usually aren't responsible for someone else's debt, and that includes a parent's. When someone dies, their debts are paid from what they left behind, their estate, under state law. A collector can contact the executor, but it can't say or hint that you have to pay with your own money.

A spouse is the main exception. A surviving spouse may owe if the debt was shared, such as a joint account, if they live in a community property state, or if they live in a state whose necessaries law covers health care. Medicaid has its own rule too. If someone got long-term care through Medicaid at 55 or older, the state has to try to recover those costs from their estate. It can't while a spouse, a child under 21, or a blind or disabled child survives them.

If your parent is alive and you're handling their bills, the bills are still theirs. When you write to the billing office for them, say what authority you have, such as a healthcare power of attorney or a guardianship, or have them sign the letter with you. The bill letter has a line for that.