What Happens to Unpaid Medical Bills?

By Rebecca Alexis - Updated May 31, 2017
Past Due medical bill

It is no secret that medical bills are a big issue for many. Some people do not have insurance, and for those who do, they often are not fully covered. Some people are still receiving medical bills years after treatment. At times, the bills are so astronomically high that there is no real way to pay them, and inevitably they can destroy people's credit. Occasionally medical bills are also fraudulent attempts to collect old debts or even paid debts.

Insurance and Medical Bills

While most insurers have stipulations that they do not pay a medical bill in full, this is often negotiable. If you have health insurance that has paid your bill but you have received supplemental bills for your part, you can often negotiate these. This is done by contacting accounts payable and offering a "full and final settlement." This works best when you have very high bills that are far beyond your ability to pay. If you have at least one quarter of the amount, you can actually offer this, explaining to the billing department that this is all you can afford and, rather than default, you wish to make a "full and final settlement" and can immediately pay the amount you can afford. Oftentimes they will accept this or a payment plan.

Insurance That Did Not Pay

If you went to a hospital or medical facility that did not accept your insurance as a method of coverage, you will receive a bill. In this instance, you should forward the bill to your insurer for reimbursement. In cases of emergency, there may be stipulations where the company will reimburse you in full. You can talk to accounts payable and explain that the bill has been submitted and you are awaiting payment, which will be forwarded upon receipt. You may also want to discuss with your insurance broker what has happened, as this can go into collection and on your credit report.


If you are uninsured and the situation is not an emergency, your first step should be to find a public hospital. Many areas--though not all--have free clinics, but they are not always accessible for all. Some medical centers will ask you to pay in accordance with what you can afford. At times, it may well be more than you can afford. If you are hit with medical bills in this situation, you often can obtain information on local medical payment assistance programs. Often the hospital will be more than happy to provide you with this information, and if you meet the requirements, you will be able to receive ample help.

Emergency Care for the Uninsured

The worst scenario someone can face is being uninsured and in need of emergency medical care. If you are able to, you may want to either mention this in the ambulance or look for a pubic hospital, if you have time to do so. Teaching hospitals are usually the best bet. They do not tend to charge as much and often will not charge at all. Also keep in mind, you are not required provide information in the case of an emergency. Though this is controversial, you can refuse to give any more than your first name and may opt to give a legal maiden name. Do not sign anything while under medication either. You also can inquire about financial aid.

Old Bills, New Collections

A common scenario is that a bill that was sold long ago to a collection agency and never paid will resurface. This happens when unscrupulous companies buy, for pennies on the dollar, what another collection agency bought similarly, long after the statute of limitations has run on these bills. The people who work in these agencies work on commission and are often ruthless. They may contact family members through one of the many sites that compile--often outdated and often illegally--public records. If your family start getting threatening calls, explain that this is illegal and tell them to deny knowing you or tell the company to cease and desist.

Best-Case Scenario

The best-case scenario for unpaid medical bills is what is called a write-off. A write-off happens when a hospital has tried, over a period of time, to collect a bill; and rather than sell it for pennies on the dollar to a collection agency, they actually can get government funding to make up for the loss or they are able to get tax deductions. This is what we all hope for. The smaller the bill, the more likely this is to happen.

About the Author

Rebecca Alexis has spent more than 10 years writing. She has been featured in major in-flight magazines, numerous newspapers, including Sweden's top newspapers, Expressen, Aftonbladet, Uppsala Nya Tidning, and several British Newspapers such as Daily Mail and The Sun.

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