Hospital Bill Forgiveness

Q I got a hospital bill and after insurance, I still owe $4,300! Can hospitals send you to collections?


A Hospitals expect payment for care. They bill primary insurance first, then secondary, then you. When you get the bill, check to make sure all insurance coverage has been applied, and check for errors.

A hospital bill can be disputed and often negotiated by calling the hospital billing office. They usually allow some flexibility for the portion that comes out of your pocket. Can’t hurt to ask. If you do agree on a total, you are expected to pay. If you don’t pay, they can send you to collections. Hospital collections, or medical debt, is often pursued aggressively. It can be reported to credit bureaus as well. It is the “top complaint” at the Consumer Financial Protection Bureau.

Hospitals that enjoy non-profit status (that’s about 3,000 or 60% of U.S. hospitals) are supposed to tell patients up front that they may be eligible for financial assistance. That law was put in place at the end of 2014 as part of the Affordable Care Act. Non-profit hospitals do not have to pay federal taxes, so they are expected to pass that savings on to the community. The financial assistance may take the form of sliding scale, discount, or charitable write-off. It depends on the patients’ needs and ability to pay, and hospital policy.

The law requires that non-profit hospitals try to identify whether a patient is eligible for assistance before sending a case to collections, report to a credit bureau or pursue the debt
in court.

A recent study by the Institute for Healthcare Policy and Innovation found that 42% of non-profit hospitals are not informing potentially eligible patients of the financial help. So be
sure to ask! When choosing a local hospital, determine if it is non-profit. Ask for a copy of its financial assistance eligibility guidelines. If you need help, call us.


“Many Hospitals Keeping Quiet on Charity Care, Study Finds,” in The Chronicle of Philanthropy. November 6, 2015.


“New Rules to Limit Tactics on Hospitals’ Fee Collection,” by Robert Pear. The New York Times
1/11/15. Available at: