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

How much time do you have?

More than you may think, especially at a nonprofit hospital. Federal tax rules give patients of nonprofit hospitals these protections:

• Before it takes an extraordinary collection action, the hospital must wait, counting from the first bill sent after you leave. The wait is at least 120 days (IRS, published July 2, 2026).
• It must warn you in writing before any such action. The warning must come in advance, at least 30 days (IRS, published July 2, 2026).
• It must accept your financial assistance application for a long time after that first bill. The time is at least 240 days (IRS, published July 2, 2026).

Extraordinary collection actions include selling the debt, reporting it to a credit bureau, delaying or refusing needed care because of an unpaid bill, and legal steps such as a lien, a lawsuit, taking money from a bank account or garnishing wages Source 11.

These rules cover nonprofit hospitals only. For-profit and government hospitals, doctors' offices and labs are not covered by them, though state law may still protect you Source 22.

What usually happens to an unpaid bill

Every provider is different, but an unpaid bill tends to move through these stages:

1. Statements and reminders. The billing office sends more statements. This is the best time to call: you can still ask for financial assistance, an itemized bill or a payment plan.
2. A collection agency. The provider may hand the account to a collection agency or sell it to a debt buyer. Among adults with medical debt, many said a collection agency had contacted them. Their share was 35.2% (Urban Institute, December 2025).
3. Credit reports. An unpaid medical collection can reach your credit report in some cases. The next section explains when.
4. A lawsuit. A provider or collector can sue. If it wins, the court can allow steps such as a wage garnishment or a lien.

None of these stages is automatic, and you can act at any of them. Our guide on what medical debt is explains each step.

Will an unpaid medical bill hurt your credit?

It can, but less often than before. There is no federal ban on medical debt in credit reports Source 55. The three national credit bureaus follow their own policy:

• Paid medical collections are left off credit reports, and an unpaid medical collection must wait a year before it can appear Source 44.
• Medical collections that started with a small balance are left off too Source 44. The key facts above give the limit.
• Larger unpaid medical collections that are more than a year old can still be reported in states without their own ban Source 55.

Some states go further. Our guide to medical debt and your credit report lists the states and what each law covers.

Whatever the state, a collection of any kind can stay on a report for at most 7 years (15 U.S.C. 1681c(a)(4), (c)(1) (Cornell LII), published 2026).

What to do first

1. Open every letter and keep it. Write down the date of the first bill. Your deadlines count from it.
2. Ask for financial assistance. Ask the billing office for the financial assistance policy and the application, fill it in and send the income proof it asks for Source 11. Our guide to charity care walks through it.
3. Ask the hospital to pause collection while it decides. Once a nonprofit hospital has your complete application, it must stop extraordinary collection actions until it decides. If you qualify, it must refund what you paid above what you owe Source 11.
4. Ask for an itemized bill. Check each line before you pay. See our guide to the itemized medical bill.
5. Ask for a payment plan you can keep. Ask whether it charges interest, and get the terms in writing.
6. Negotiate what is left. Our guide on how to negotiate a medical bill has the order to follow.

If a debt collector contacts you

A collection agency has to follow federal rules that the hospital's own billing office often does not:

• It must send you the details of the debt in its first message or within 5 days (CFPB, published January 29, 2024) after it.
• You can dispute the debt in writing within 30 days (CFPB, published January 29, 2024). Once you do, it must pause collecting the disputed amount until it answers. This is called debt validation.
• It is presumed to break the rules if it calls you about one debt more often than the weekly limit. The weekly limit on calls about one debt is 7 (12 CFR 1006.14(b)(2) (Cornell LII), published 2026).

Old debts need care. Every state sets a time limit for lawsuits on a debt, usually 3 years (CFPB, published October 28, 2026) to 6 years (CFPB, published October 28, 2026). After it passes, a collector may not sue or threaten to sue, but it can still ask you to pay, and in some states a small payment or a written promise to pay can restart the clock. If you are sued anyway, answer the court by the deadline on the papers: the time limit protects you only if you raise it Source 99. This is the statute of limitations.

If a collector breaks the rules, you can complain to the Consumer Financial Protection Bureau at consumerfinance.gov/complaint or 1-855-411-2372 Source 1010.

Where to get more help

• The hospital's billing office or financial counselor, for financial assistance and payment plans.
• Free legal aid if you are sued: find a program in your state at LawHelp.org.
• Our list of organizations that help pay medical bills.