Logo_Horizontal white

What to Do When You Get a Medical Bill You Can’t Afford


Fact: Healthcare is expensive in the United States. Whether dealing with routine check-ups, unexpected hospital visits, or chronic conditions, medical bills can range from hundreds to thousands of dollars and can be quite intimidating. So, what happens when you get one you can’t afford?

First up, review your bill.

  • Ask for an itemized bill covering everything you’re being charged for and review for errors like services or medication you didn’t receive or any duplicate charges.
  • If insured, look over the explanation of benefits (EOB) from your insurance company. If part of your bill should have been covered but wasn’t, contact them to sort it out.

Then, explore your options. Putting the bill on a credit card is never a good idea because you may lose the ability to negotiate for lower amounts. Also, a hospital almost certainly will charge less interest and be more forgiving than a credit card issuer.


Unlike other debts, there’s often room to negotiate medical bill balances and payments. Do your research and ask if there are any waivers, hardship or relief programs available, or a discount for making a prompt down payment or full payment. If you don’t feel comfortable negotiating on your own, look up for professional companies and individuals to review your bills and negotiate on your behalf.

While this process may be complicated, there isn’t an immediate downside in delaying payment. The major consumer credit bureaus (Experian, Equifax and TransUnion) won’t include unpaid medical bills on your credit reports for 180 days.

Flexible Financing

  • Hospitals, clinics and medical service providers may offer financial assistance to low-income patients. Some states even require both for-profit and non-profit hospitals to have financial assistance programs, but you may need to ask about their availability.
  • Healthcare credit cards with special financing options could help pay for out-of-pocket expenses not covered by insurance, making medical expenses more manageable. However, this shouldn’t necessarily be the first option you pursue if repaying the debt will make it difficult to afford essentials.

State-Sponsored Programs

Every state has its own unique programs to help with medical bills and costs. Check the State Health Insurance Assistant Program Here, site for details about what’s available where you live.

Some examples include:

  • Texas Health and Human Services Here.
  • Your Texas Benefits Here.
  • Arizona Department of Economic Security Here.
  • Arizona Self Help Here.
  • New Mexico Aging and Long-Term Services Here.

Charitable Campaigns

Generous charities may provide full or partial assistance paying a bill. Your healthcare provider or patient advocate may be able to advise on programs available to you based on your needs and health circumstances.

Tax Credits

Lawfully present immigrants can get tax credits to help pay premiums and cost-sharing for health insurance through the Marketplaces if they make between 100% and 400% of the federal poverty level. To get this help, they cannot be offered affordable insurance through their job or be eligible to enroll in Medicaid due to their immigration status.

Government Assistance

Lawfully present immigrants with qualified status for 5 years or more; refugees, asylees, and other humanitarian immigrants; veterans and military families; and pregnant women and children for some states, may qualify for assistance programs such as Medicare, Medicaid, and Children’s Health Insurance Program (CHIP).

  • Medicare: A joint federal and state program that helps with medical costs for some people with limited income and resources.
  • Medicaid: An optional medical coverage program that states elect to provide to their residents. Eligibility criteria vary by state and individuals need to apply for coverage and re-enroll/recertify annually.
  • CHIP: Insurance program that provides low-cost health coverage to children in families that earn too much money to qualify for Medicaid but not enough to buy private insurance. Each state program has its own rules about who qualifies for CHIP.

Mixed Status

Many immigrant families are of “mixed status,” with members having different immigration and citizenship statuses.

These families can apply for premium tax credits or lower out-of-pocket costs for private insurance for their dependent family members who are eligible for coverage in the Marketplace. They can also apply for Medicaid and CHIP coverage for their dependent family members.

Federal and state Marketplaces and state Medicaid and CHIP agencies can’t require applicants to provide information about the citizenship or immigration status of any family or household members who aren’t applying for coverage. States also can’t deny benefits to an applicant because a family or household member who isn’t applying hasn’t disclosed their citizenship or immigration status.


If you’re unable to negotiate a lower bill, the provider or collection agency might accept a settlement.

Look up health care costs on Healthcare Bluebook and FAIR Health to obtain an estimate for the same procedures to act as reliable data for your negotiations.

Keep in mind that health care providers may charge different rates based on insurance status. If not insured and not eligible for Medicaid, you may at least ask to pay the same amount as insurance companies.

The Takeaway

Medical bills are stressful, and oftentimes confusing. But it’s important to remember that you always have options and that you can’t ignore them, even if you can’t afford to pay them.

Like with any debt, ignoring medical bills could lead to a negative impact on your credit score, collectors, and additional stress. So, do your research, ask your provider for help, and utilize assistance (local, state, and federal) resources at hand.

What to read next