I’m unemployed and got a surprise medical bill that I can’t afford to pay — and now the debt has gone to collections and my credit score has plummeted. What can I do?

Know your rights

Surprise medical bills can happen to anyone, whether they’re insured or uninsured. However, as of Jan. 1, 2022, there are legal protections in place that can help shield you from these unexpected financial burdens.

Under the No Surprises Act, those with health insurance are protected against:

• Surprise bills for most emergency services, non-emergency services via out-of-network providers at in-network facilities, and out-of-network air ambulance services.
• Out-of-network coinsurance and copayment costs for most emergency services and some non-emergency care.
• Balance bills or out-of-network charges for services provided by out-of-network providers when you visit an in-network facility (for example, being charged an out-of-network fee by an anesthesiologist when you're at an in-network hospital).

In addition, health care providers and facilities are required to provide you with an easy-to-understand notice that breaks down all the applicable billing protections and who to contact if you feel your rights have been violated.

For those without health insurance, the No Surprises Act also requires providers to give you a “good faith estimate” of costs before you get care. If your final charges exceed their estimate by $400 or more, you can dispute the claim within 120 days of the time you're billed.

If you get an unexpected bill despite the stipulations above, you should take swift action to dispute the charges that were inappropriately applied to you in order to preserve your rights.

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Not all unpaid medical debt will ruin your credit score

There are also protections in place to protect your credit score when medical bills become a burden.

Specifically, if you fall behind on your medical bills and your balance is under $500, credit reporting agencies won't report medical collections on your credit record. Therefore, the unpaid balance won't affect your credit history.

Equifax, Experian, and TransUnion also provide a 365 day wait period for you to resolve the issue before any outstanding medical debt collections appear on your credit record — even if you owe sums above $500.

If you can resolve your payment issues before that waiting period, though, your credit score shouldn't be adversely affected by your debt.

What to do if you have unpaid bills

If you have outstanding bills that aren't in violation of the No Surprises Act, you should aim to find a speedy solution — ideally, before it’s sent to collections prior to the expiration of the 365-day wait period.

You have some options to consider:

• Look into financial assistance programs (also known as charity care), which non-profit hospitals must provide under the Affordable Care Act. These programs provide free or discounted health care for individuals who need help paying their medical bills.
• Negotiate directly with the provider to reduce the bill down to an amount you can afford.
• Ask the provider to accept an interest-free repayment plan.
• Explore government assistance programs in your state or check out the Centers for Medicare & Medicaid Services for information on how to protect yourself against surprise medical bills.

It's best to take swift action as many providers are willing to work with patients who are proactive and express a desire to try to get their bills paid in a timely manner.