Dealing with a medical bill

Free tools

• Surprise medical bill checker — whether the No Surprises Act limits an out-of-network bill.
• Good faith estimate dispute checker — for uninsured or self-pay patients billed $400 or more above the estimate.

If you can’t afford a hospital bill

The IRS says Section 501(r), added by the Affordable Care Act, imposes requirements on organizations that operate one or more hospital facilities and want to be described in Section 501(c)(3) (tax-exempt charitable hospitals); it does not by its terms cover for-profit hospitals. (IRS, Requirements for 501(c)(3) hospitals under the Affordable Care Act – Section 501(r) (last reviewed 02-Jul-2026))

A 501(c)(3) hospital organization must establish, for each hospital facility, a written financial assistance policy (FAP) and a written emergency medical care policy. (26 C.F.R. § 1.501(r)-4(a)) The hospital's FAP must apply to all emergency and other medically necessary care provided by the facility (including by substantially-related entities) and must be widely publicized. (26 C.F.R. § 1.501(r)-4(b)(1)(i)-(ii))

The IRS says widely publicizing the FAP includes putting the FAP, application form and plain language summary on a website and offering free paper copies on request by mail and in public areas of the hospital, at least the emergency room (if any) and admissions. (IRS, Financial assistance policy and emergency medical care policy - Section 501(r)(4) (last reviewed 03-Jul-2026)) The IRS says the hospital must put a conspicuous written notice on billing statements about the availability of financial assistance, with a phone number for FAP information and the web address of the FAP documents. (IRS, Financial assistance policy and emergency medical care policy - Section 501(r)(4) (last reviewed 03-Jul-2026))

For a FAP-eligible patient, a 501(c)(3) hospital may charge no more than the amounts generally billed (AGB) to insured patients for emergency or other medically necessary care, and less than gross charges for all other care covered by the FAP. (26 C.F.R. § 1.501(r)-5(a))

Before a nonprofit hospital can go after the debt

The IRS says extraordinary collection actions (ECAs) include selling a patient's debt, reporting adverse information to credit bureaus, deferring/denying or requiring payment before medically necessary care because of unpaid prior FAP-covered bills, and actions requiring a legal or judicial process. (IRS, Billing and collections - Section 501(r)(6) (last reviewed 02-Jul-2026))

The IRS summarizes the rules as a 120-day notification period and a 240-day application period, both starting on the date the first post-discharge billing statement is provided. (IRS, Billing and collections - Section 501(r)(6) (last reviewed 02-Jul-2026))

“(i) Notifies the individual about the FAP as described in paragraph (c)(4) of this section before initiating any ECAs to obtain payment for the care and refrains from initiating such ECAs (with the exception of an ECA described in paragraph (b)(1)(iii) of this section) for at least 120 days from the date the hospital facility provides the first post-discharge billing statement for the care;”
26 C.F.R. § 1.501(r)-6(c)(3)(i)

The FAP application period begins on the date care is provided and ends no earlier than the 240th day after the first post-discharge billing statement (it can end later in certain cases). (26 C.F.R. § 1.501(r)-1(b)(3)) The IRS says the hospital must give written notice that financial assistance is available, identify the ECAs it intends to take, and set a deadline for those ECAs no earlier than 30 days after the notice. (IRS, Billing and collections - Section 501(r)(6) (last reviewed 02-Jul-2026))

The IRS says that when a patient is found FAP-eligible, the hospital must take reasonably available measures to reverse ECAs, generally including vacating judgments, lifting levies or liens (with exceptions), and removing adverse information from the patient's credit report. (IRS, Billing and collections - Section 501(r)(6) (last reviewed 02-Jul-2026))

Medical debt and your credit report

The CFPB states that on July 11, 2025 a federal court (E.D. Tex.) vacated the CFPB's January 2025 rule that would have barred medical debt from credit reports, at the joint request of the CFPB and the plaintiffs; so that rule is not in effect. (CFPB, Prohibition on Creditors and Consumer Reporting Agencies Concerning Medical Information (Regulation V) rule page (page last modified Feb. 24, 2026))

The CFPB's consumer answer currently says unpaid medical debt that is more than 365 days delinquent from the date of service and over $500 could appear on your credit reports, and advises reviewing your reports (the page does not cite the legal source of these thresholds). (CFPB, Ask CFPB: Do medical bills affect my credit...? (last reviewed Sep. 5, 2025; page last modified Oct. 6, 2025))

The CFPB's page says FCRA permits furnishing and considering coded medical debt information as long as it does not identify, or allow inference of, the specific provider or the nature of the medical services, products or devices; the rule materials are now for reference only. (CFPB, Regulation V medical information rule page (page last modified Feb. 24, 2026))

Asking for an itemized bill

Federal law gives Medicare beneficiaries (only for items or services paid for under Medicare) the right to submit a written request to the physician, provider or supplier for an itemized statement. (42 U.S.C. § 1395b-7(b)(1) (govinfo, U.S. Code 2023 edition)) For such a Medicare request, the provider must furnish the itemized statement within 30 days of the request. (42 U.S.C. § 1395b-7(b)(2)(A)) We did not find a general federal right to an itemized bill for privately insured or uninsured patients; many states have their own rules, and hospitals usually provide one on request.

Where to complain

CMS says you can submit a No Surprises complaint online (the 'Get Started' form linked from the CMS complaint page) or over the phone at 1-800-985-3059. (CMS, Submit a complaint (page last modified 09/19/2026)) CMS says it will review complaints and submitted documents and, if it needs more information, will get in touch within 60 days using your preferred contact method. (CMS, Submit a complaint (page last modified 09/19/2026))

The CFPB says to submit a complaint online or by calling (855) 411-CFPB (2372) if a debt collector contacts you about a surprise medical bill or surprise medical charges appear as negative items on your credit report. (CFPB, Ask CFPB: What should I know about debt collection and credit reporting if my medical bill was sent to collections? (page last modified Aug. 4, 2025))

Guides

• What is the No Surprises Act?
• What is a good faith estimate?
• Can a hospital send me to collections without telling me?
• Charity care at a hospital
• Can medical debt go on my credit report?
• How to dispute a medical bill