What to Do If You’re Drowning in Medical Debt

Let’s be honest: no one expects to walk out of a hospital with a five-figure bill. But in the U.S., that’s a reality for millions of people. One unexpected procedure or trip to the ER can leave you with crushing debt that threatens your financial stability.

One in five Americans is struggling with medical debt. And here’s the good news: there are real, actionable steps you can take to lighten the load, reduce the bill, or even get parts of it forgiven altogether.

If you’re feeling overwhelmed and not sure where to start, let’s walk through the steps together. Because yes, you can take back control.

1. Ask for help—early and often
   The moment that bill arrives—or even better, the moment you know it’s coming—pick up the phone and call the hospital’s billing department. What you’re looking for is their financial assistance policy, sometimes called charity care.

Nonprofit hospitals are legally required to have these programs, and they can slash your bill in half—or more—depending on your income and situation. Even if you’re not eligible for full forgiveness, you may still be able to negotiate a much lower amount.

The key here? Don’t wait. The sooner you speak up, the more options you have.

2. Don’t pay the sticker price
   Medical bills often list the “chargemaster rate”—think of it as the MSRP of healthcare. It’s the full, inflated cost that’s mainly used in insurance negotiations. But very few people actually pay that amount.

If you’re uninsured or paying out of pocket, ask:
“What’s the rate you charge insurance companies or Medicare for this service?”

You can also use websites like Healthcare Bluebook to find fair prices for specific procedures in your area. Knowing the going rate gives you leverage when you negotiate.

3. Be politely persistent
   Negotiating medical bills isn’t always a one-and-done conversation. It might take several calls, a few follow-up emails, and a whole lot of patience.

Don’t be afraid to channel your inner advocate. Keep notes, get names, and don’t give up. Sometimes, it’s the third or fourth conversation that unlocks a meaningful discount or affordable payment plan.

The billing office deals with these situations every day. You’re not asking for special treatment, you’re asking for a plan that’s realistic for your circumstances.

4. Whatever you do, don’t put it on a credit card
   Do not swipe your credit card to pay off a medical bill just to get it off your plate.

Why? Because credit cards come with high interest rates. That means your 0% hospital bill can turn into a 20% credit card nightmare overnight. And once it’s on your card, the hospital has been paid, so there’s no incentive for them to negotiate or help you set up a payment plan.

Instead, ask the provider if they offer no-interest monthly payment options and most do.

5. Pay your other essentials first
   If you’re deciding between your medical bill and your rent, pay the rent. Your mortgage, utilities, car payment. Those are critical to your daily life. Medical debt, while stressful, is not the most urgent financial obligation.

In fact, medical debt is treated differently by credit reporting agencies. It doesn’t hit your credit report until it’s 180 days past due, and even then, its impact is lower than other types of debt. That gives you time to figure things out.

It’s not about ignoring the bill instead it’s about prioritizing wisely.

6. Stop the calls with a no-contact letter
   If debt collectors are already calling, you can ask them to stop. Legally, you have that right.

Here’s how:

• Send a written request (called a “no-contact letter”) telling them to cease communication
• Keep a copy of the letter for your records
• If they continue to call after that, they’re violating federal law

You can find templates online from reliable resources like the National Consumer Law Center, which also publishes a helpful guide called Surviving Debt.

7. Work with a trusted nonprofit advocate
   If you’re feeling truly stuck, overwhelmed, or unsure what to do next, a nonprofit credit counseling agency can help you sort through your options.

These organizations can:

• Review your full financial picture
• Help you negotiate with creditors
• Set up a debt management plan, if needed

Just be careful. If a company offers a “debt solution” and tries to push a loan on you? Walk away. That’s not in your best interest. Look for certified counselors through the National Foundation for Credit Counseling instead.

Quick checklist: What to do if you’re drowning in medical debt

• Call your hospital and ask about financial assistance or charity care
• Negotiate the price—don’t settle for the chargemaster rate
• Don’t put it on a credit card—ask for a zero-interest payment plan
• Prioritize essential expenses like housing, food, and transportation
• Know your rights—send a no-contact letter if collectors won’t stop
• Get help from a nonprofit counselor before considering extreme options
• Be kind to yourself—you didn’t choose this debt, but you can manage it

Finally

Medical debt is uniquely emotional. You didn’t go on a shopping spree. You got sick. You needed help. And now you’re staring at a bill that feels like a second illness.

But here’s what I want you to remember: you are not powerless.
There are resources. There are laws on your side.

Ask for help. Advocate for yourself. Focus on what you can control. And know that every bit of progress you make is a win.