Debt and credit · Updated Oct 2026

My medical bill is too high

Start by asking for an itemized bill and checking it against your insurance explanation of benefits. The federal No Surprises Act protects many insured patients from surprise out-of-network bills for emergency care and some other care. If you were uninsured or paid yourself and the bill is at least $400 more than your good faith estimate, you can start a federal dispute within 120 days of the bill. Nonprofit hospitals must have financial assistance (charity care) policies.

This plan is general legal information, not legal advice. RobinClaim is not a law firm. Laws and deadlines change and have exceptions: check with the official source or a lawyer or legal aid office about your own case.

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Do now

  1. Ask the provider for an itemized bill with billing codes. Don't pay a bill you don't understand yet.

    Why: Billing errors such as duplicate charges are common, and you can't dispute what you can't see.

  2. If you answered “Yes” to “Did you have health insurance for this care?”

    Compare it with your insurer's explanation of benefits (EOB). Call the insurer about any denied or unexpected charges.

    Why: Sometimes the provider billed you before insurance paid, or the claim was coded wrong.

  3. Ask the billing office whether you can pause collection while you dispute or apply for financial assistance.

    Why: Nonprofit hospitals must give time to apply for financial assistance before some collection actions.

This week

  1. Apply for the hospital's financial assistance (charity care) program and ask for a written decision.

    Why: Nonprofit hospitals must have a written financial assistance policy and accept applications for at least 240 days after the first bill after discharge.

  2. If you answered “No, or I paid myself (self-pay)” to “Did you have health insurance for this care?” and If you answered “Yes” to “Did you get a written good faith estimate before the care?”

    If you were uninsured or self-pay and the bill is at least $400 more than your good faith estimate, start a patient-provider dispute with CMS.

    Why: You must start within 120 calendar days of the bill date; there's a $25 fee, which is deducted from what you owe if you win.

  3. If you answered “Yes” to “Did you have health insurance for this care?” and If you answered “Yes” to “Was this emergency care, or care from an out-of-network doctor at an in-network hospital?”

    If you think you got a surprise out-of-network bill, contact the No Surprises Help Desk (CMS) at 1-800-985-3059 or online.

    Why: Federal law limits balance billing for emergency care and some out-of-network care at in-network facilities.

  4. If you answered “Yes” to “Did you have health insurance for this care?”

    File an appeal with your insurer for denied claims.

    Why: Insurers must give you an appeal process for denials.

If it's not resolved

  1. If you owe the bill, ask for a no-interest payment plan or a discount for paying a lump sum. Get it in writing.

    Why: Many providers offer plans or prompt-pay discounts.

  2. If you answered “Yes” to “Has the bill been sent to collections?”

    If the bill is in collections, use your debt-collector rights: dispute in writing within the validation period.

    Why: The collector must stop and verify the debt if you dispute in time.

  3. Check your credit reports for errors related to the bill.

    Why: Wrong medical collection entries can be disputed.

Deadlines

Start a patient-provider dispute (uninsured/self-pay)

General rule: Within 120 calendar days of the initial bill; bill must be at least $400 more than the good faith estimate

Official source

Apply for nonprofit hospital financial assistance

General rule: At least 240 days from the first post-discharge billing statement (hospital can allow longer)

Official source

Nonprofit hospital must wait before 'extraordinary collection actions' (like lawsuits or credit reporting)

General rule: At least 120 days from the first post-discharge bill, after notifying you about financial assistance

Official source

Documents to gather

  • Itemized bill
  • Good faith estimate, if you got one
  • Insurance card and explanation of benefits (EOB)
  • Proof of income for financial assistance (pay stubs, tax return)
  • Notes of calls with the provider and insurer

Letters you can send

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Request for itemized bill and financial assistance

Ask for an itemized bill, a financial assistance application, and a hold on collections while you review.

[Today's date]

[Provider name]
Billing Department
[Provider address]

Re: Account [Account number], date of service [Date of service]

Please send me an itemized bill for this account, including billing codes for each charge. Please also send me your financial assistance policy and application.

I am reviewing the charges and may apply for financial assistance. Please hold this account from collections while my request is pending.

[Your name]
[Your address]

Where to go

Costs

The CMS patient-provider dispute costs $25 (non-refundable, but deducted from the bill if you win). Financial assistance applications and insurer appeals are free.

Talk to a lawyer if

  • You were sued over a medical bill
  • Your wages or bank account are being taken for a medical bill
  • A nonprofit hospital sued or reported you without telling you about financial assistance
  • The bill is very large and insurance denied coverage for an emergency

Free help

Free civil legal aid for people with low income: find your local program through the Legal Services Corporation (lsc.gov/about-lsc/what-legal-aid/get-legal-help) or LawHelp.org (lawhelp.org). Many legal aid offices handle debt collection lawsuits, garnishment and bankruptcy. Servicemembers can use their base legal (JAG) office. Many hospitals also have patient financial counselors at no cost.

Guides for your state

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Guides for every state

Questions

What is the start a patient-provider dispute (uninsured/self-pay)?

Within 120 calendar days of the initial bill; bill must be at least $400 more than the good faith estimate

What is the apply for nonprofit hospital financial assistance?

At least 240 days from the first post-discharge billing statement (hospital can allow longer)

What is the nonprofit hospital must wait before 'extraordinary collection actions' (like lawsuits or credit reporting)?

At least 120 days from the first post-discharge bill, after notifying you about financial assistance

When should I talk to a lawyer?

You were sued over a medical bill; Your wages or bank account are being taken for a medical bill; A nonprofit hospital sued or reported you without telling you about financial assistance; The bill is very large and insurance denied coverage for an emergency.

How much does it cost?

The CMS patient-provider dispute costs $25 (non-refundable, but deducted from the bill if you win). Financial assistance applications and insurer appeals are free.

Plans by state

This plan is the same in every state. Each state's RobinClaim page lists its courts, agencies and deadlines:

Sources

Plan checked Oct 2026. Independently fact-checked 2026-10-24. Some details could not be fully verified; see the notes in each section.

This plan is general legal information, not legal advice. RobinClaim is not a law firm. Laws and deadlines change and have exceptions: check with the official source or a lawyer or legal aid office about your own case. How we research.